Propranolol (inderal) for tardive dyskinesia and extrapyramidal side effects from neuroleptics: Possible involvement of beat - adrenergic mechanisms

Wilbur, Robert; Kulik, Frank A.

doi:10.1016/0364-7722(81)90105-3

Cited by 21 publications

(2 citation statements)

References 17 publications

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“…Propranolol was examined as a treatment of TS in the 1980s. The reports involved a total of 26 subjects examined in open-label single cases or case series of which 65% improved rapidly and often dramatically (including complete reversal) to low doses of the drug, up to 80 mg/day [136][137][138][139]. There was also a double-blind, crossover design study evaluating only 4 patients utilizing 10 times the dose of the open trials (up to 800 mg/day) in which 2 improved [140].…”

Section: Medical Therapymentioning

confidence: 99%

Management of Tardive Syndrome: Medications and Surgical Treatments

Factor

2020

Neurotherapeutics

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Tardive syndrome (TS) is an iatrogenic, often persistent movement disorder caused by drugs that block dopamine receptors. It has a broad phenotype including movement (orobuccolingual stereotypy, dystonia, tics, and others) and nonmotor features (akathisia and pain). TS has garnered increased attention of late because of the Food and Drug Administration approval of the first therapeutic agents developed specifically for this purpose. This paper will begin with a discussion on pathogenesis, clinical features, and epidemiology. However, the main focus will be treatment options currently available for TS including a suggested algorithm based on current evidence. Recently, there have been significant advances in TS therapy, particularly with the development of 2 new vesicular monoamine transporter type 2 inhibitors for TS and with new data on the efficacy of deep brain stimulation. The discussion will start with switching antipsychotics and the use of clozapine monotherapy which, despite the lack of higher-level evidence, should be considered for the treatment of psychosis and TS. Anti-dyskinetic drugs are separated into 3 tiers: 1) vesicular monoamine transporter type 2 inhibitors, which have level A evidence, are approved for use in TS and are recommended first-choice agents; 2) drugs with lower level of evidence for efficacy including clonazepam, Ginkgo biloba, and amantadine; and 3) drugs that have the potential to be beneficial, but currently have insufficient evidence including levetiracetam, piracetam, vitamin B 6 , melatonin, baclofen, propranolol, zolpidem, and zonisamide. Finally, the roles of botulinum toxin and surgical therapy will be examined. Current therapies, though improved, are symptomatic. Next steps should focus on the prevention and reversal of the pathogenic process.

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Section: Medical Therapymentioning

confidence: 99%

Management of Tardive Syndrome: Medications and Surgical Treatments

Factor

2020

Neurotherapeutics

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“…In addition beta-blocking drugs were shown by several authors to have a beneficial effect against neuroleptic induced tardive dyskinesia (Bacher and Lewis. 1980; Wilbur and Kulik. 1981;Kamiol and Portela.…”

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confidence: 99%