Benzodiazepines for neuroleptic-induced tardive dyskinesia

Abstract

Background: Tardive dyskinesia (TD) is a potentially disfiguring movement disorder of the orofacial region often caused by use of neuroleptic drugs. A wide range of strategies have been used to help manage TD and, for those who are unable to have their antipsychotic medication stopped or substantially changed, the benzodiazapine group of drugs has been suggested as a useful adjunctive treatment.

Objectives: To determine the clinical efficacy of benzodiazepines for people with neuroleptic-induced tardive dyskinesia (TD) schizophrenia or other chronic mental illnesses.

Search strategy: Electronic searches of Biological Abstracts (1982-1995), the Cochrane Schizophrenia Group's Register of trials (1995), EMBASE (1980-1995), LILACS (1982-1995), MEDLINE (1966-1995), PsycLIT (1974-1995), SCISEARCH (1995) and handsearching the references of all identified studies.

Selection criteria: The inclusion criteria for all randomised studies were that they should focus on people with schizophrenia or other chronic mental illnesses and neuroleptic-induced TD and compare the use of benzodiazepines to placebo or no intervention.

Data collection and analysis: The reviewers extracted the data independently and the odds ratio (95% CI) or the average difference (95% CI) were estimated. The reviewers assumed that people who dropped out had no improvement.

Main results: Two trials were able to be included in this review. The results of this review do not allow any confident interpretations on the clinical utility of benzodiazepines for the treatment of neuroleptic-induced TD. From the data combined in this review, benzodiazepines have no distinct advantages over placebo in the treatment of TD. Data on side effects were not reported in the included trials.

Reviewer's conclusions: No clear statement about the efficacy of benzodiazepines drugs, to treat neuroleptic-induced TD, could be provided.