Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-22T08:25:17.040Z Has data issue: false hasContentIssue false

The Effects of Clozapine on Tardive Dyskinesia

Published online by Cambridge University Press:  03 January 2018

Jeffrey A. Lieberman*
Affiliation:
Hillside Hospital, Glen Oaks, New York, and Associate Professor of Psychiatry, Albert Einstein School of Medicine, New York
Bruce L. Saltz
Affiliation:
Hillside Hospital, New York, and Associate Professor of Psychiatry, Albert Einstein College of Medicine, New York
Celeste A. Johns
Affiliation:
Hillside Hospital, New York
Simcha Pollack
Affiliation:
Hillside Hospital, New York, and Associate Professor of Statistics, St John's University, Jamaica, New York
Michael Borenstein
Affiliation:
Hillside Hospital, New York
John Kane
Affiliation:
Department of Psychiatry, Hillside Hospital, New York, and Professor of Psychiatry, Albert Einstein School of Medicine, New York, USA
*
Hillside Hospital, Division of Long Island Jewish Medical Center, PO Box 38, Glen Oaks, New York, USA

Abstract

This article reviews eight published studies that describe clozapine's effects on TD and examines the outcome of 30 patients with TD treated with clozapine for up to 36 months. These data indicate that TD response to clozapine is variable but that approximately 43% of cases, particularly those with dystonic features, improved after clozapine treatment. Methodological limitations of the studies described, however, preclude definitive conclusions, which must await appropriately controlled trials.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1991 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, P. H. & Braestrup, C. (1986) Evidence for different states of the dopamine D1 receptor: clozapine and fluperlapine may preferentially label an adenylate cyclase-coupled state of the D1 receptor. Journal of Neurochemistry, 47, 18221831.CrossRefGoogle Scholar
Arnt, J. & Hyttel, J. (1984) Differential inhibition by dopamine D1 and D2 antagonists of circling behavior induced by dopamine agonists in rats with unilateral 6–hydroxy-dopamine lesions. European Journal of Pharmacology, 102, 349359.CrossRefGoogle Scholar
Baldessarini, R. J., Cole, J. O., Davis, J. M., et al (1980) Tardive Dyskinesia: Task Force Report. Washington, DC: APA.Google Scholar
Barnes, T. R. E. & Braude, W. M. (1985) Akathisia variants and tardive dyskinesia. Archives of General Psychiatry, 42, 874878.CrossRefGoogle ScholarPubMed
Burke, R. E., Fahn, S., Jankovic, J., et al (1982) Tardive dystonia: late onset and persistent dystonia caused by antipsychotic drugs. Neurology, 32, 13351346.CrossRefGoogle ScholarPubMed
Burki, H. R., Sayers, A. C., Ruch, W., et al (1975) Clozapine and the dopamine hypothesis of schizophrenia, a critical appraisal. Pharmacopsychiatry, 8, 115121.CrossRefGoogle ScholarPubMed
Caine, E. D., Polinsky, R. J., Kartzinel, R., et al (1979) The trial use of clozapine for abnormal involuntary movement disorders. American Journal of Psychiatry, 136, 317320.Google ScholarPubMed
Carroll, B. J., Curtiss, C. G. & Kokmen, E. (1977) Paradoxical response to dopamine agonists in tardive dyskinesia. American Journal of Psychiatry, 134, 785790.Google ScholarPubMed
Chiodo, L. A. & Bunney, B. S. (1983) Typical and atypical neuroleptics: differential effects of chronic administration on the activity of A9 and A10 midbrain dopaminergic neurons. Journal of Neuroscience, 3, 16071619.CrossRefGoogle ScholarPubMed
Cole, J. O., Gardos, G., Tarsy, D., et al (1980) Drug trials in persistent dyskinesia. In Tardive Dyskinesia, Research and Treatment (eds W. E. Fann, R. C. Smith, J. M. Davis, et al), pp. 419427. New York: SP Medical and Scientific Books.CrossRefGoogle Scholar
Gerbino, L., Shopsin, B. & Collora, M. (1980) Clozapine in the treatment of tardive dyskinesia: an interim report. In Tardive Dyskinesia, Research and Treatment (eds W. E. Fann, R. C. Smith, J. M. Davis, et al), pp. 475489. New York: SP Medical and Scientific Books.CrossRefGoogle Scholar
Gerlach, J., Koppelhus, P. & Helweg, E. (1974) Clozapine and haloperidol in a single-blind crossover trial: therapeutic and biochemical aspects in the treatment of schizophrenia. Acta Psychiatrica Scandinavica, 50, 410424.CrossRefGoogle Scholar
Jeste, D. V. & Wyatt, R. J. (1982) Therapeutic strategies against tardive dyskinesia: two decades of experience. Archives of General Psychiatry, 39, 803816.Google Scholar
Juul Povisen, U., Noring, U., Fog, R., et al (1985) Tolerability and therapeutic effect of clozapine. A retrospective investigation of 216 patients treated with clozapine for up to 12 years. Acta Psychiatrica Scandinavica, 71, 176185.Google Scholar
Kane, J. & Smith, J. (1982) Tardive dyskinesia: prevalence and risk factors. Archives of General Psychiatry, 39, 473481.Google Scholar
Kane, J., Woerner, M., Lieberman, J., et al (1986) Tardive dyskinesias and drugs. Drug Development Research, 9, 4151.CrossRefGoogle Scholar
Kane, J., Honigfeld, G., Singer, J., et al (1988) Clozapine for the treatment-resistant schizophrenic: a double blind comparison versus chlorpromazine. Archives of General Psychiatry, 45, 789796.CrossRefGoogle Scholar
Lieberman, J., Kane, J., Woerner, M., et al (1984) Prevalence of tardive dyskinesia in elderly samples. Psychopharmacology Bulletin, 20, 2226.Google ScholarPubMed
Lieberman, J., Kane, J., Johns, C., et al (1986) Clozapine: clinical evidence of novel effects. Clinical Neuropharmacology, 9, 140.Google Scholar
Lieberman, J., Pollack, S., Lesser, M. S., et al (1988) Pharmacologic characterization of tardive dyskinesia. Journal of Clinical Psychopharmacology, 8, 254260.CrossRefGoogle ScholarPubMed
Lieberman, J., Kane, J. & Johns, C. (1989a) Clozapine: guidelines for clinical management. Journal of Clinical Psychiatry, 50, 329338.Google ScholarPubMed
Lieberman, J., Alvir, J., Mukherjee, S., et al (1989b) Treatment of tardive dyskinesia with bromocriptine: a test of the receptor modification strategy. Archives of General Psychiatry, 46, 908913.CrossRefGoogle ScholarPubMed
Ljungberg, T. & Ungerstedt, U. (1978) Classification of neuroleptic drugs according to their ability to inhibit apomorphine-induced locomotion and gnawing: evidence for two different mechanisms of action. Psychopharmacology, 56, 239247.CrossRefGoogle ScholarPubMed
McClelland, H. A., Dutta, D., Metcalfe, A., et al (1986) Mortality and facial dyskinesia. British Journal of Psychiatry, 148, 310316.CrossRefGoogle ScholarPubMed
McMillen, B. A. & Shore, P. A. (1978) Comparative effects of clozapine and alpha-adrenoceptor blocking drugs on regional noradrenaline metabolism in rat brain. European Journal of Pharmacology, 52, 225230.CrossRefGoogle ScholarPubMed
Meltzer, H. Y. & Luchins, D. J. (1984) Effect of clozapine in severe tardive dyskinesia: a case report. Journal of Clinical Psychopharmacology, 4, 286287.CrossRefGoogle ScholarPubMed
Reynolds, G. P., Garret, N. J., Rupniak, N., et al (1983) Chronic clozapine treatment of rats down-regulates cortical 5–HT2 receptors. European Journal of Pharmacology, 89, 325326.Google Scholar
Rosengarten, H., Schweitzer, J. W. & Friedhoff, A. J. (1986) Selective dopamine D2 receptor reduction enhances a D1 mediated oral dyskinesia in rats. Life Science, 39, 2935.CrossRefGoogle ScholarPubMed
Rupniak, N. M. J., Hall, M. D., Mann, S., et al (1985) Chronic treatment with clozapine, unlike haloperidol, does not induce changes in striatal D2 receptor function in the rat. Biochemical Pharmacology, 34, 27552763.Google Scholar
Savers, A. C., Burki, H. R., Ruch, W., et al (1975) Neuroleptic-induced hypersensitivity of striatal dopamine receptors in the rat as a model of tardive dyskinesia. Effects of clozapine, haloperidol, loxapine and chlorpromazine. Psychopharmacology, 41, 97104.Google Scholar
Schmutz, J. & Eichenberger, E. (1982) Clozapine. Chronicles Drug Discovery, 1, 3959.Google Scholar
Simpson, G., Lee, J. H. & Shrivastava, R. K. (1978) Clozapine in tardive dyskinesia. Psychopharmacology, 56, 7580.CrossRefGoogle ScholarPubMed
Small, J. G., Milstein, V., Marhenke, J. D., et al (1987) Treatment outcome with clozapine in tardive dyskinesia, neuroleptic sensitivity, and treatment-resistant psychosis. Journal of Clinical Psychiatry, 48, 263267.Google ScholarPubMed
Yassa, R. & Jones, B. (1985) Complications of tardive dyskinesia: a review. Psychosomatics, 26, 305313.CrossRefGoogle ScholarPubMed
Youssef, H. A. & Waddington, J. L. (1987) Morbidity and mortality in tardive dyskinesia: associations in chronic schizophrenia. Acta Psychiatrica Scandinavica, 75, 7477.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.