Vitamin B<sub>6</sub> may benefit patients with tardive dyskinesia.




Am J Psychiatry

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Tardive dyskinesia is a term that refers to the involuntary movements brought on as a result of certain medications, specifically antipsychotics that are typically taken for schizophrenia. The term, which was introduced in the mid-sixties, refers to an iatrogenic disease1, a disease that is caused by either a medicine or by the efforts of medical personnel. Symptoms of tardive dyskinesia range from mild to disruptive and include involuntary movements, primarily of the face, neck, arms, fingers, legs, and torso.2 Unfortunately, the condition is considered potentially irreversible though there are many studies reporting different methods of treatment. Risk factors for tardive dyskinesia include the use of antipsychotic medication along with increasing age and length of time on medication.
The treatment options that have emerged over the years have not shown a great deal of promise. The first line of defense is to eliminate the antipsychotic drug suspected of causing the condition if this is indeed the cause and if removal of the drug is feasible. Other options include low doses of a benzodiazepine, anticholinergic drugs, botulinum toxin injections, and vitamin E.3 Treatments primarily focus on reduction of symptoms and the treatment is determined based on the severity of symptoms or on how much the symptoms disrupt the patient’s life.
Recently, a new study was published looking at yet another treatment option for reducing the symptoms of tardive dyskinesia. While not a large sampling of patients, the results of this study seem promising. This double-blind crossover trial involving fifteen inpatients with schizophrenia evaluated the treatment of tardive dyskinesia with vitamin B6. These patients were randomized to a vitamin B6 treatment group or a placebo group for 4 weeks. Using the Extrapyramidal Symptom Rating Scale patients were assessed weekly. During the third week, the assessments began to show that the B6 group seemed to be displaying fewer symptoms than the placebo group. The mean scores on the parkinsonism and dyskinetic movement subscales were significantly better in the third week of treatment with vitamin B6 than during the placebo period. These results prompted the research group to determine that vitamin B6 might be effective in reducing the symptoms associated with tardive dyskinesia.4


1. American College of Neuropsychopharmacology FDA Task Force 1973, Fann and Lake 1976.
2. Newell KM. The changing effector pattern of tardive dyskinesia during the course of neuroleptic withdrawal. Exp Clin Psychopharmacol. 2001 Aug;9(3):262-8.
3. Tarsy D. Tardive Dyskinesia. Curr Treat Options Neurol. 2000 May;2(3):205-214.
4. Lerner V. Vitamin B(6) in the treatment of tardive dyskinesia: a double-blind, placebo-controlled, crossover study. Am J Psychiatry. Sep 2001;158(9):1511-4.