1. Arch Gen Psychiatry. 2001 Nov;58(11):1049-52.

Melatonin treatment for tardive dyskinesia: a double-blind, placebo-controlled,
crossover study.

Shamir E, Barak Y, Shalman I, Laudon M, Zisapel N, Tarrasch R, Elizur A, Weizman
R.

Abarbanel Mental Health Center, 15 KKL St, Bat-Yam 59100, Israel.
drshamir@hotmail.com

Comment in:
Arch Gen Psychiatry. 2001 Nov;58(11):1054-5.

BACKGROUND: Antipsychotics remain the mainstay of drug intervention in the
management of schizophrenia. However, long-term treatment with antipsychotics is
associated with a variety of movement disorders, the most disabling of which is
tardive dyskinesia (TD), which occurs in up to 50% of patients hospitalized with
chronic schizophrenia. The pathophysiology of TD is still unclear and no definite
treatment exists. Both dopamine receptor supersensitivity and oxidative
stress-induced neurotoxicity in the nigrostriatal system are apparently
implicated. The pineal hormone melatonin is a potent antioxidant and attenuates
dopaminergic activity in the striatum and dopamine release from the hypothalamus.
Thus, it may have a beneficial effect for both the treatment and prevention of
TD. METHODS: Using a double-blind, placebo-controlled, crossover study, we
evaluated the efficacy of 10 mg/d of melatonin for 6 weeks in 22 patients with
schizophrenia and TD. The primary outcome measure was the change from baseline in
Abnormal Involuntary Movement Scale (AIMS) score. RESULTS: The decrease (mean +/-
SD) in AIMS score was 2.45 +/- 1.92 for the melatonin and 0.77 +/- 1.11 for the
placebo treatment groups (P<.001). No adverse events or side effects were noted.
CONCLUSION: This is the first clinical evidence for efficacy of melatonin in the
treatment of TD.

PMID: 11695951 [PubMed - indexed for MEDLINE]