One of the major problems associated with long-term neuroleptic treatment is tardive dyskinesia(TD), for which there is no satisfactory treatment. Recently proposed hypothesis and studies reported that some patients of TD are associated with neuroleptic dysfuntion resulting from excess free radical production during catecholamine metabolism. Therefore the author ´attempted to assess the effect of a powerful free radical scavenging agent, vitamin E in the treatment of TD.
The author compared the effect of vitamin E with that of placebo in a double-blind randomized crossover study. The subjects were 23 male patients with tardive dyskinesia who were diagnosed as chronic schizophrenia, and have been hospitalized in Yong-In Mental Hospital. These subjects were assigned randomly to receive either placebo or vitamin E for 4 weeks. The dose of vitamin E was raised from 400IU/day for the first week, 400IU b. i. d. for the second week, and 400IU t. i. d. for the final 2 weeks. After 4 week washout period, the subjects crossed over to the other treatment for the second 4 week period. The subjects were evaluated and videotaped biweekly by two trained raters using the Abnormal Involuntary Movement Scale (AIMS).
The results were as follows :
1) Upper extremity was the most frequently involved area of dyskinetic movement, followed by tongue, jaw, oral and perioral area.
2) There were no significant correlations between demographic variables (duration of illness, medication and TD) and AIMS score.
3) Two-way repeated-measures ANOVA for the two-period crossover design revealed significant differences between placebo and vitamin E treatment with the respect to jaw movement, severity of abnormal movement, global judgement and total AIMS score.
4) The most therapeutic effect was seen in jaw, followed by tips and perioral area.
5) There was no reported complication after vitamin E treatment during the study.
|