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The adult population of a large mental hospital was screened for tardive dyskinesia (TD). Approximately 11% of the hospital population showed signs of TD; females and the elderly were over-represented in the TD group. A representative sample of those with TD was selected and a control (non-TD) patient was chosen to match each of the TD subjects in age, sex, length of hospitalization, diagnosis, and race. The charts of these subjects were searched for any indices of brain damage and the complete psychotropic medication history was recorded. There was no difference between the TD and controls in the amount of psychotropics ingested, in the duration of administration, in the kinds of drugs, or in the organicity history. Women as a group, however, tended to have more polypharmacy than men. The role of neuroleptics in TD is discussed as well as other possible etiological factors.

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The authors studied the effect of codeine on 12 severely depressed patients who failed to respond to tricyclic antidepressants. They all were in involution. Eight patients received codeine in combination with other tricyclic antidepressants and only one of them showed improvement. Four depressed patients received codeine alone and none of them improved. The patients were kept on codeine up to three weeks. The dose was gradually increased from 90 mg/day to 180 mg/day. All patients suffered from severe constipation--more than what they had on tricyclic antidepressant medication. All of the patients experienced a sedative effect. None of them had euphoria and none of them developed dependence. After the failure of codeine, the patients finally accepted electroconvulsive therapy or monoamine oxidase inhibitors, and with one exception, all improved.