There has been very little progress in treating or preventing antipsychotic-induced tardive dyskinesia.

Abstract

Commentary on : Bergman H, Walker DM, Nikolakopoulou A, et al . Systematic review of interventions for treating or preventing antipsychotic-induced tardive dyskinesia. Health Technol Assess 2017;21:1-218. Tardive dyskinesia (TD) is a relatively frequent side effect of long-term use of antipsychotics and there is conflicting evidence if the incidence of TD is lower with second-generation antipsychotics (excluding clozapine), compared with first-generation antipsychotics. Until now there is no evidence-based algorithm to prevent or to treat TD. This systematic review1 evaluated any intervention for treating or preventing deterioration of symptoms of antipsychotic-induced TD in adult patients. Included were all relevant studies, regardless of language, about adults who had used antipsychotic drugs for ≥3 months and in whom the antipsychotic doses had been stable for at least 1 month. The authors included 112 randomised trials and eight prospective cohort studies. Seventy-nine separate interventions were the focus of the trials, whereas prospective cohort studies focused on comparing different strategies for antipsychotics. These were grouped into three broad categories: 1. Reducing antipsychotic dose. 2. Switching antipsychotic drug. (3) Adjunctive treatments in …