Tardive Dyskinesia Treatment
One side effect of psychoactive medications is tardive dyskinesia (TD), a movement disorder similar to Tourette syndrome. Medical researchers are attempting several methods to treat the disorder, including changing an affected patient's medication or using a different variety of drugs. The most effective treatment is prevention – or discontinuing medication even though tardive dyskinesia symptoms may persist.
The first benzodiazepine drug was chlordiazepoxide hydrochloride, which was marketed for many years by the Hoffman-LaRoche corporation under the brand name Librium. It is essentially a tranquilizer which functions as an anti-convulsant and a muscle relaxant. The medication has traditionally been used to treat insomnia, seizures and even anxiety attacks.
Although there have been no harmful side effects of short-term use, long-term use can lead to drug resistance and dependence. Use of such drugs in combination with alcohol or other depressants can also magnify the effect. Studies carried out in India and Israel failed to demonstrate any appreciable change in tardive dyskinesia patients when benzodiazepine was used as an adjunctive treatment, although none of the subjects in the study reported adverse effects. One part of the study suggested that a few tardive dyskinesia patients may receive a small benefit from the use of benzodiazepine, but overall, the results did not justify its use on a routine basis.
Typical Antipsychotics vs. Atypical
In a 2000 supplemental issue of the Journal of Clinical Psychiatry, four researchers from the University of Cincinnati College of Medicine's Department of Psychiatry reported that
"Exposure to typical antipsychotics poses a risk for the emergence of tardive dyskinesia. Atypical antipsychotics may have advantages over typical agents in the treatment of patients with mood disorders complicated by psychotic features."
The researchers added:
"Typical and atypical antipsychotics appear to be comparably effective in the treatment of acute mania."
"Typical" antipsychotic medications are also labeled as "first generation" and include those discovered and developed during the 1950s. "Atypical" refers to those introduced 20 years later, although the first such antipsychotic, clozapine, was actually developed in the 1950s.
Although the University of Cincinnati study indicates that typical and atypical antipsychotics are of approximately equal effectiveness when used in the treatment of certain mental disorders, many of them do have potentially harmful side effects. In addition, the use of atypical antipsychotics does not preclude the development of tardive dyskinesia; it simply delays its onset.
Partial Dopamine Agonists and Amine-Depleting Drugs
Dopamine agonists are medications that activate receptors where dopamine is not present. These are used in the treatment of Parkinson's disease. Amine-depleting medications actually reduce the levels of dopamine in the brain as well as serotonin. The most effective of these appears to be tetrabenazine, which was approved for use in the U.S. in August of 2008 for the treatment of Huntington's disease.