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Benzodiazepines for neuroleptic-induced tardive dyskinesiaBhoopathi PSS, Soares-Weiser K
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SummaryBenzodiazepines for neuroleptic-induced tardive dyskinesiaTardive dyskinesia is a persistent and disfiguring set of repetitive movements, often of the facial area and is strongly associated with the long term use of antipsychotic medication. Various treatments have been tried since the disorder was first recognised but it still remains a common and distressing condition. Valium belongs to the group of drugs called benzodiazepines, which are often used as a last resort treatment intervention. We identified three relevant studies; two did not suggest any benefits to those taking benzodiazepines. The third study suggests some degree of improvement in the symptoms but it was a small study and we are unsure of the clinical meaning of the outcome. Benzodiazepines should remain a treatment of very last resort for people with schizophrenia or schizophrenia-like illnesses.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 4, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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July 20. 1996 AbstractBackgroundTardive dyskinesia (TD) is a disfiguring movement disorder, often of the orofacial region, frequently caused by the use of neuroleptic drugs. A wide range of strategies have been used to help manage tardive dyskinesia, and for those who are unable to have their antipsychotic medication stopped or substantially changed, the benzodiazepine group of drugs have been suggested as a useful adjunctive treatment. ObjectivesTo determine the effects of benzodiazepines for neuroleptic-induced tardive dyskinesia in people with schizophrenia or other chronic mental illnesses. Search strategy1. Electronic searches Selection criteriaWe included all randomised clinical studies focusing on people with schizophrenia (or other chronic mental illnesses) and neuroleptic-induced tardive dyskinesia that compared benzodiazepines with placebo or no intervention. Data collection and analysisWe independently extracted data from the studies and ensured that they were reliably selected, and quality assessed. For homogenous dichotomous data we calculated random effects, relative risk (RR), 95% confidence intervals (CI) and, where appropriate, numbers needed to treat (NNT) on an intention-to-treat basis. We synthesised continuous data from valid scales by using a weighted mean difference (WMD). For continuous outcomes we preferred endpoint data to change data. Main resultsWe identified three trials (total N=56, one additional trial since 2002, n=24). Using benzodiazepines as an adjunctive treatment did not result in any clear changes for a series of tardive dyskinesia medium-term outcomes (n=30, 2 RCTs, RR not improved to clinically important extent 1.08 CI 0.57 to 2.05). One trial (n=24) found end point abnormal movement scores to be better for those receiving adjunct benzodiazepines(WMD AIMS -3.22 CI -4.63 to -1.81 ). Less than 10% in both groups left these studies before completion and none of the studies reported clear adverse effects. Authors' conclusionsOne small study reports some preliminary evidence that benzodiazepines may have some effect in neuroleptic induced tardive dyskinesia. Inconclusive results from other studies means routine clinical use is not indicated and these treatments remain experimental. |