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Tardive Dyskinesia (Holistic)

Tardive Dyskinesia (Holistic)

About This Condition

Involuntary muscle tics may be a consequence of long-term “antipsychotic” medication use. According to research or other evidence, the following self-care steps may be helpful.
  • Get some extra E

    Reduce the severity of TD by taking 1,600 IU of vitamin E every day under a doctor's supervision

  • Discover lecithin

    Improve symptoms by taking 25 grams of this nutritional supplement twice a day, providing 35 grams of phosphatidyl choline per day

  • Mix in manganese

    Prevent onset by taking 15 mg of manganese a day, or help reverse the condition by taking up to 60 mg per day under a doctor’s supervision

  • Manage movement with melatonin

    With the supervision of a knowledgeable doctor, take 10 mg of this natural hormone each night to help reduce abnormal movements

About

About This Condition

Tardive Dyskinesia (TD) is a condition of abnormal, repetitive, uncontrollable movements that develop after a long-term use of so-called antipsychotic medications used to treat schizophrenia and related psychiatric disorders. The term “tardive” (which means “late”) is used because the condition appears only after long-term use of these drugs, which include chlorpromazine (Thorazine), thioridazine (Mellaril), and trifluoperazine (Stelazine). Dyskinesia means “abnormal movement.”

The uncontrollable movements of TD can interfere greatly with a person’s quality of life. TD may gradually diminish in severity after the medication is discontinued, but all too often the problem is permanent, persisting after withdrawal from the drugs that caused the condition. Conventional treatment for TD is unsatisfactory, so prevention is considered crucial. It is important that people requiring antipsychotic drugs be given the lowest effective dose and that treatment be discontinued as soon as it is feasible.

Symptoms

Symptoms of TD include repetitive and involuntary movements (tics), most often of the facial muscles and tongue (such as lip smacking), although any muscle in the body can be affected (e.g., moving legs back and forth). Symptoms may be mild or severe and can interfere with eating and walking.

Supplements

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Supplement Why
3 Stars
Vitamin E
1,600 IU daily
Vitamin E has been shown to reduce the severity of tardive dyskinesia.

Vitamin E has been found in a number of studies to reduce the severity of TD. In a double-blind trial, people with TD were randomly assigned to receive vitamin E (800 IU per day for two weeks and 1,600 IU per day thereafter) or a placebo. Vitamin E was significantly more effective than placebo in reducing involuntary movements.1 An uncontrolled study of 20 people with TD reported that 1,600 IU of vitamin E per day may be the optimal amount;2 this large amount should be supervised by a healthcare practitioner. Other studies have also found that vitamin E supplements reduce the severity of TD.3 , 4 , 5 Two studies failed to show a beneficial effect of vitamin E.6 , 7 However, the people in those studies had been receiving neuroleptics for at least ten years, and research has shown that vitamin E is most effective when started within the first five years of neuroleptic treatment.8 , 9

2 Stars
Ginkgo
240 mg per day
Ginkgo biloba extract EGb 761 improved symptoms of tardive dyskinesia by about 30% in schizophrenic patients.
In a double-blind trial, treatment with Ginkgo biloba extract EGb 761 (240 mg per day) for 12 weeks significantly improved symptoms of tardive dyskinesia by about 30% in schizophrenic patients.10 Ginkgo is believed to work by functioning as an antioxidant.
2 Stars
Lecithin (Phosphatidyl Choline)
25 grams lecithin twice a day, providing 35 grams of phosphatidyl choline per day
Lecithin and phosphatidyl choline may help improve symptoms.

Choline and lecithin have both been used for people with TD. While some studies have shown a beneficial effect,11 , 12 , 13 others have reported variable improvement14 or no improvement.15 In a small, two-week, double-blind trial, people with TD were given 25 grams of lecithin twice a day (providing 35 grams of phosphatidyl choline per day), or a matching placebo. All participants experienced significant improvement of symptoms.16

2 Stars
Manganese
For prevention: 15 mg daily while taking anti-psychotic medication; treat under a doctor's supervision: 60 mg daily
Supplementing with manganese may prevent onset or help reverse the condition.

One doctor has found that administering the trace mineral manganese (15 mg per day) can prevent the development of TD and that higher amounts (up to 60 mg per day) can reverse TD that has already developed.17 Other researchers have reported similar improvements with manganese.18 , 19

2 Stars
Melatonin
Take under medical supervision: 10 mg daily at bedtime
Taking melatonin may help reduce abnormal movements.

In a double-blind trial, supplementation with 10 mg of melatonin each night for six weeks reduced abnormal movements by 23.8% in patients with TD, compared with 8.4% in the placebo group, a statistically significant difference.20

1 Star
Branched-Chain Amino Acids
Refer to label instructions
Supplementing with branched-chain amino acids may reduce excess phenylalanine in people with tardive dyskinesia.

Preliminary research has linked TD to the inability of the body to metabolize the amino acid phenylalanine . Supplementing with branched-chain amino acids (BCAA), including valine, isoleucine, and leucine, could reduce excess phenylalanine in people with this disorder. In one trial, researchers examined the effects of BCAA supplementation in people with TD (from 150 mg per 2.2 pounds body weight, up to 209 mg per 2.2 pounds body weight) after breakfast and one hour before lunch and dinner for two weeks.21 The BCAA mixture included equal parts valine and isoleucine plus 33% more leucine than either of the other two amino acids. Of nine people treated, six experienced at least a 58% reduction in symptoms, and all nine had a least a 38% decrease.

1 Star
DMAE
Refer to label instructions
Taking dimethylaminoethanol may help reduce symptoms.

Dimethylaminoethanol (DMAE) is a natural choline precursor. Although some preliminary data suggested that DMAE could decrease TD symptoms,22 most studies show that DMAE is no more effective than placebo for TD.23

1 Star
Evening Primrose Oil
Refer to label instructions
Several people have experienced improvement while taking evening primrose oil.

Several people have experienced an improvement in TD while taking evening primrose oil (EPO).24 In a double-blind study, however, supplementing with EPO (12 capsules per day) resulted only in a minor, clinically insignificant improvement.25

1 Star
L-Tryptophan
Refer to label instructions
Animal research and preliminary human reports suggest that L-tryptophan may help  reduce the severity of symptoms.

Animal research and preliminary human reports suggest that L-tryptophan may be helpful for reducing the severity of tardive dyskinesia symptoms.26 , 27 , 28 Typical supplementation has begun with 2 grams per day of L-tryptophan, increasing to as much as eight grams per day, sometimes accompanied by a low-protein, high-carbohydrate diet and 25 mg/day of niacin (nicotinic acid).29

1 Star
Vitamin B3
Refer to label instructions
In some studies, taking vitamin B3 as niacin or niacinamide, along with other nutrients, appeared to prevent the development of tardive dyskinesia.

During a ten-year period, doctors at the North Nassau Mental Health Center in New York treated approximately 11,000 people with schizophrenia with a megavitamin regimen that included vitamin C (up to 4 grams per day), vitamin B3 —either as niacin or niacinamide—(up to 4 grams per day), vitamin B6 (up to 800 mg per day), and vitamin E (up to 1,200 IU per day). During that time, not a single new case of TD was seen, even though many of the people were taking neuroleptic drugs.30 Another psychiatrist who routinely used niacinamide , vitamin C, and vitamin B-complex over a 28-year period rarely saw TD develop in her patients.31 Further research is needed to determine which nutrients or combinations of nutrients were most important for preventing TD. The amounts of niacinamide and vitamin B6 used in this research may cause significant side effects and may require monitoring by a doctor.

1 Star
Vitamin B6
Refer to label instructions
In some studies, taking vitamin B6 along with other nutrients appeared to prevent the development of tardive dyskinesia.

During a ten-year period, doctors at the North Nassau Mental Health Center in New York treated approximately 11,000 people with schizophrenia with a megavitamin regimen that included vitamin C (up to 4 grams per day), vitamin B3 —either as niacin or niacinamide—(up to 4 grams per day), vitamin B6 (up to 800 mg per day), and vitamin E (up to 1,200 IU per day). During that time, not a single new case of TD was seen, even though many of the people were taking neuroleptic drugs.32 Another psychiatrist who routinely used niacinamide , vitamin C, and vitamin B-complex over a 28-year period rarely saw TD develop in her patients.33 Further research is needed to determine which nutrients or combinations of nutrients were most important for preventing TD. The amounts of niacinamide and vitamin B6 used in this research may cause significant side effects and may require monitoring by a doctor.

1 Star
Vitamin B-Complex
Refer to label instructions
In some studies, taking vitamin B-complex along with other nutrients appeared to prevent the development of tardive dyskinesia.

During a ten-year period, doctors at the North Nassau Mental Health Center in New York treated approximately 11,000 people with schizophrenia with a megavitamin regimen that included vitamin C (up to 4 grams per day), vitamin B3 —either as niacin or niacinamide—(up to 4 grams per day), vitamin B6 (up to 800 mg per day), and vitamin E (up to 1,200 IU per day). During that time, not a single new case of TD was seen, even though many of the people were taking neuroleptic drugs.34 Another psychiatrist who routinely used niacinamide , vitamin C, and vitamin B-complex over a 28-year period rarely saw TD develop in her patients.35 Further research is needed to determine which nutrients or combinations of nutrients were most important for preventing TD. The amounts of niacinamide and vitamin B6 used in this research may cause significant side effects and may require monitoring by a doctor.

1 Star
Vitamin C
Refer to label instructions
In some studies, taking vitamin C along with other nutrients appeared to prevent the development of tardive dyskinesia

During a ten-year period, doctors at the North Nassau Mental Health Center in New York treated approximately 11,000 people with schizophrenia with a megavitamin regimen that included vitamin C (up to 4 grams per day), vitamin B3 —either as niacin or niacinamide—(up to 4 grams per day), vitamin B6 (up to 800 mg per day), and vitamin E (up to 1,200 IU per day). During that time, not a single new case of TD was seen, even though many of the people were taking neuroleptic drugs.36 Another psychiatrist who routinely used niacinamide , vitamin C, and vitamin B-complex over a 28-year period rarely saw TD develop in her patients.37 Further research is needed to determine which nutrients or combinations of nutrients were most important for preventing TD. The amounts of niacinamide and vitamin B6 used in this research may cause significant side effects and may require monitoring by a doctor.

References

1. Adler LA, Peselow E, Rotrosen J, et al. Vitamin E treatment of tardive dyskinesia. Am J Psychiatry 1993;150:1405-7.

2. Hashim S, Sajjad A. Vitamin E in the treatment of tardive dyskinesia: a preliminary study over 7 months at different doses. Int Clin Psychopharmacol 1988;13:147-55.

3. Sajjad SHA. Vitamin E in the treatment of tardive dyskinesia: a preliminary study over 7 months at different doses. Int Clin Psychopahrmacol 1998;13:147-55.

4. Elkashef AM, Ruskin PE, Bacher N, Barrett D. Vitamin E in the treatment of tardive dyskinesia. Am J Psychiatry 990;147:505-6.

5. Lohrr JB, Cadet JL, Lohr MA. Alpha-tocopherol in tardive dyskinesia. Lancet 1987;1:913-4.

6. Shriqui CL, Bradwejn J, Annable L, Jones BD. Vitamin E in the treatment of tardive dyskinesia: a double-blind placebo-controlled study. Am J Psychiatry 1992;149:391-3.

7. Dorevitch A, Kalian M, Shlafman M, Lerner V. Treatment of long-term tardive dyskinesia with vitamin E. Biol Psychiatry 1997;41:114-6.

8. Egan MF, Hyde TH, Albers GW, et al. Treatment of tardive dyskinesia with vitamin E. Am J Psychiatry 1992;149:773-7.

9. Lohr JB, Caligiuri MP. A double-blind placebo-controlled study of vitamin E treatment of tardive dyskinesia. J Clin Psychiatry 1996;57:167-73.

10. Zhang W-F, Tan Y-L, Zhang X-Y, RCK Chan, et al. Extract of Ginkgo biloba Treatment for Tardive Dyskinesia in Schizophrenia J Clin Psychiatry 2011;72:615-21.

11. Davis KL, Hollister LE, Barchas JD, Berger PA. Choline in tardive dyskinesia and Huntington's disease: preliminary results from a pilot study. Life Sci 1976;19:1507-15.

12. Gelenberg AJ, Doller-Wojcik JC, Growdon JH. Choline and lecithin in the treatment of tardive dyskinesia: preliminary results from a pilot study. Am J Psychiatry 1979;136:772-6.

13. Growdon JH, Hirsch MJ, Wurtman RJ, Wiener W. Oral choline administration to patients with tardive dyskinesia. N Engl J Med 1977;297:524-7.

14. Nasrallah HA, Dunner FJ, Smith RE, et al. Variable clinical response to choline in tardive dyskinesia. Psychol Med 1984;14:697-700.

15. Anderson BG, Reker D, Ristich M, et al. Lecithin treatment of tardive dyskinesia—a progress report. Psychopharmacol Bull 1982;18:87-8.

16. Jackson IV, Nuttall EA, Perez-Cruet J. Treatment of tardive dyskinesia with lecithin. Am J Psychiatr 1979;136:1458-60.

17. Kunin RA. Manganese in dyskinesias. Am J Psychiatry 1976;133:105.

18. Norris JP, Sams RE. More on the use of manganese in dyskinesia. Am J Psychiatry 1997;134:1448.

19. Hoffer A. Tardive dyskinesia treated with manganese. Can Med Assoc J 1977;117:859.

20. Shamir E, Barak Y, Shalman I, et al. Melatonin treatment for tardive dyskinesia. A double-blind, placebo-controlled, crossover study. Arch Gen Psychiatry 2001;58:1049-52.

21. Richardson MA, Bevans ML, Weber JB, et al. Branched chain amino acids decrease tardive dyskinesia symptoms. Psychopharmacology 1999;143:358-64.

22. Casey DE, Denney D. Dimethylaminoethanol in tardive dyskinesia. N Engl J Med 1974;291:797 [letter].

23. Soares, KV, McGrath JJ. The treatment of tardive dyskinesia-a systematic review and meta-analysis. Schizophr Res 1999;39:1-16 [review].

24. Vaddadi KS. Essential fatty acids and neuroleptic drug-associated tardive dyskinesia: preliminary clinical observations. IRCS Med Sci 1984;12:678.

25. Vaddadi KS, Courtney P, Gilleard CJ, et al. A double-blind trial of essential fatty acid supplementation in patients with tardive dyskinesia. Psychiatry Res 1989;27:313-23.

26. Kozell L, Sandyk R, Wagner GC, Fisher H. The effects of L-tryptophan on haloperidol-induced movement disorder in the rat. Life Sci 1987;41:1739-44.

27. Sandyk R, Bamford CR, Khan I, Fisher H. L-tryptophan in neuroleptic-induced tardive dyskinesia. Int J Neurosci 1988;42:127-30.

28. Sandyk R, Consroe PF, Iacono RP. L-tryptophan in drug-induced movement disorders with insomnia. N Engl J Med 1986;314:1257.

29. Sandyk R, Consroe PF, Iacono RP. L-tryptophan in drug-induced movement disorders with insomnia. N Engl J Med 1986;314:1257.

30. Tkacz C. A preventive measure for tardive dyskinesia. J Int Acad Prev Med 1984;8:(5)5-8.

31. Toll N. To the editor. J Orthomolec Psychiatry 1982;11:42.

32. Tkacz C. A preventive measure for tardive dyskinesia. J Int Acad Prev Med 1984;8:(5)5-8.

33. Toll N. To the editor. J Orthomolec Psychiatry 1982;11:42.

34. Tkacz C. A preventive measure for tardive dyskinesia. J Int Acad Prev Med 1984;8:(5)5-8.

35. Toll N. To the editor. J Orthomolec Psychiatry 1982;11:42.

36. Tkacz C. A preventive measure for tardive dyskinesia. J Int Acad Prev Med 1984;8:(5)5-8.

37. Toll N. To the editor. J Orthomolec Psychiatry 1982;11:42.

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