Melatonin supplementation in Tardive dyskinesia.




Arch Gen 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. 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 study examined the role of melatonin in Tardive dyskinesia. The study stated Tardive dyskinesia is present in 50% of patients hospitalized with schizophrenia. This double-blind, placebo-controlled, crossover study selected 22 patients that suffered from both tardive dyskinesia and schizophrenia. The patients were administered 10 mg of melatonin daily, for 6 weeks. The Abnormal Involuntary Movement Scale score was used to measure the outcome of this study. Using this score, there was a decrease in symptoms of tardive dyskinesia in the group that received the melatonin. The authors concluded that this was the first clinical study that provided evidence of efficacy of melatonin in the treatment of tardive dyskinesia.3 Since melatonin has few side effects, it may be a complement to existing therapies for patients with this disorder.


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. Shamir E, et al. Melatonin Treatment for Tardive Dyskinesia. Arch Gen Psychiatry. Nov 2001;58:1049-1052.