New and emerging treatments for symptomatic tardive dyskinesia

Abstract

The aim of this review is to assess new, emerging, and experimental treatment options for tardive dyskinesia (TD). The methods to obtain relevant studies for review included a MEDLINE search and a review of studies in English, along with checking reference lists of articles. The leading explanatory models of TD development include dopamine receptor supersensitivity, GABA depletion, cholinergic deficiency, neurotoxicity, oxidative stress, changes in synaptic plasticity, and defective neuroadaptive signaling. As such, a wide range of treatment options are available. To provide a complete summary of choices we review atypical antipsychotics along with resveratrol, botulinum toxin, Ginkgo biloba, tetrabenazine, clonazepam, melatonin, essential fatty acids, zonisamide, levetiracetam, branched-chain amino acids, drug combinations, and invasive surgical treatments. There is currently no US Food and Drug Administration-approved treatment for TD; however, prudent use of atypical antipsychotics with routine monitoring remain the cornerstone of therapy, with experimental treatment options available for further management.

Valbenazine granted breakthrough drug status for treating tardive dyskinesia

“…Another practice is the switch to different drugs, for instance, use of atypical neuroleptics. Benzodiazepines, such as clonazepam; amantadine; levetiracetam; piracetam; propranolol; vitamin B6; ginkgo biloba; reserpine; anticholinergics and, in particular, tetrabenazine, may provide some symptomatic relief from tardive syndromes [1,6,[9][10][11].…”

“…Valbenazine allows an only once-daily administration [1,20]. Similar to deutetrabenazine, which is not in the focus of this review, valbenazine is tested in clinical trials for the treatment of patients with tardive dyskinesia [1,11,20].…”

Surgical Treatment of Tardive Dystonia in Nepal: A Case Report

“…Other leading explanatory models include dopamine receptor supersensitivity, depletion of GABA(Gamma Amino butyric Acid) receptors, defi ciency of cholinergic activities, neurotoxicity, changes in synaptic plasticity and defective neuroadaptive signaling. 9 The incidence of TD is higher in middle aged and elderly patients mainly women and the risk is still higher in postmenopausal women 13 and our case is a perimenopausal women.…”

Antipsychotic-Induced Tardive Syndromes: Clinical Features and Treatment Approaches

“…29,30 Tetrabenazin ve rezerpinin geç diskinezi ve geç distoni için en etkili ilaçlar olduğu gösterilmiştir. 29,31 Klonazepam ile naltrekson kombinasyonunun, muhtemelen beyin GABA ve bazal ganglionlar ensefalinerjik nöronlar üzerinde etkileşimin bir sonucu olarak, geç diskinezi iyileştirmede etkili olduğu bulunmuştur. 32 …”