RESUMO
Twenty-one nonschizophrenic and 12 schizophrenic outpatients with tardive dyskinesia (TD) were followed up for a mean of 12.0 and 8.6 months, respectively, following discontinuation of neuroleptic therapy. Of the 33 patients, only one demonstrated complete reversal of TD. Cumulative survival curves of the length of time to first improvement (reduction in movement ratings by 50% of baseline) did not differ between the two groups. The median time to first improvement was seven months. If a patient can be kept off of a neuroleptic regimen for 18 months, the estimated probability of showing a 50% reduction in movement is 87.2%. In the nonschizophrenic group, depressed mood was negatively correlated with severity of abnormal movements.
Assuntos
Antipsicóticos/administração & dosagem , Discinesia Induzida por Medicamentos/fisiopatologia , Transtornos Mentais/fisiopatologia , Esquizofrenia/fisiopatologia , Antipsicóticos/efeitos adversos , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/fisiopatologia , Transtorno Depressivo/psicologia , Discinesia Induzida por Medicamentos/etiologia , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Recidiva , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Fatores de TempoRESUMO
A double-blind randomized clinical trial was conducted among 10 post-menopausal women with tardive dyskinesia (TD) to test the effect of estrogen replacement of the severity of abnormal movements and other outcome variables. After 3 weeks of treatment, the mean Abnormal Involuntary Movement Scale (AIMS) score decreased by 38% in the estrogen group and by 9% in the placebo group; the difference between groups was marginally significant (p less than 0.10). However, the small sample size and the imbalance between groups in baseline AIMS scores do not allow us to rule out the confounding effects of other prognostic factors. There were no significant differences between treatment groups for parkinsonian and psychological symptoms at any visit or for changes in these variables between visits. The findings of this preliminary trial are consistent with the results of other human and animal investigations, and they support the need for future research to understand the role of estrogens in the neuropathology and treatment of TD.