Cochrane · systematic review · CD000208

Miscellaneous treatments for antipsychotic‐induced tardive dyskinesia

Soares‐Weiser, K, Rathbone, J, Ogawa, Y, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Schizophrenia2 versionsAMSTAR 2: not assessed

SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.

Questions

current version

GRADE rated

No studies

Included studies

No studies 18 · 40%Ungraded 0 · 0%Very low 14 · 31.1%Low 11 · 24.4%Moderate 2 · 4.4%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Current version only

ALKALOID ‐ DIHYDROGENATED ERGOT ALKALOIDS versus PLACEBO for antipsychotic‐induced tardive dyskinesia

Population: female and male 59‐80 (mean) years old patients with antipsychotic‐induced tardive dyskinesia

CD000208.PUB2 (current) · 5 questions

Outcome	Effect	Evidence	Status / GRADE
Tardive dyskinesia: No clinically important improvement ALKALOID ‐ DIHYDROGENATED ERGOT ALKALOIDS vs PLACEBO	RR 0.45 [0.21, 0.97]	1 study · 28 participants	Low Downgraded: risk of bias, imprecision
Tardive dyskinesia: Deterioration of symptoms ALKALOID ‐ DIHYDROGENATED ERGOT ALKALOIDS vs PLACEBO	RR 0.33 [0.01, 7.55]	1 study · 28 participants	Very low Downgraded: risk of bias, imprecision
Adverse effects ‐ any adverse effect ALKALOID ‐ DIHYDROGENATED ERGOT ALKALOIDS vs PLACEBO	RR 2.33 [0.75, 7.23]	1 study · 28 participants	Very low Downgraded: risk of bias, imprecision
Acceptability of treatment (measured by participants leaving the study early) ALKALOID ‐ DIHYDROGENATED ERGOT ALKALOIDS vs PLACEBO	RR 0.33 [0.02, 7.32]	2 studies · 48 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Social confidence, social inclusion, social networks, or personalised quality of life ‐ not reported ALKALOID ‐ DIHYDROGENATED ERGOT ALKALOIDS vs PLACEBO	no estimate extracted	NR	No studies

ANTIEPILEPTIC ‐ LEVETIRACETAM versus PLACEBO for antipsychotic‐induced tardive dyskinesia

Population: female and male 47‐54 years old (mean) patients with various psychiatric conditions and antipsychotic‐induced tardive dyskinesia

CD000208.PUB2 (current) · 5 questions

Outcome	Effect	Evidence	Status / GRADE
Tardive dyskinesia: No clinically important improvement ‐ not reported ANTIEPILEPTIC ‐ LEVETIRACETAM vs PLACEBO	no estimate extracted	NR	No studies
Tardive dyskinesia: Deterioration of symptoms ‐ not reported ANTIEPILEPTIC ‐ LEVETIRACETAM vs PLACEBO	no estimate extracted	NR	No studies
Adverse effects ‐ any adverse effect ANTIEPILEPTIC ‐ LEVETIRACETAM vs PLACEBO	RR 0.51 [0.25, 1.04]	1 study · 69 participants	Low Downgraded: risk of bias, imprecision
Acceptability of treatment (measured by participants leaving the study early) ANTIEPILEPTIC ‐ LEVETIRACETAM vs PLACEBO	RR 1.01 [0.46, 2.22]	2 studies · 119 participants	Very low Downgraded: risk of bias, imprecision, inconsistency
Social confidence, social inclusion, social networks, or personalised quality of life ‐ not reported ANTIEPILEPTIC ‐ LEVETIRACETAM vs PLACEBO	no estimate extracted	NR	No studies

ANXIOLYTIC ‐ BUSPIRONE versus PLACEBO for antipsychotic‐induced tardive dyskinesia

Population: female and male 33‐year old (mean) patients with schizophrenia and antipsychotic‐induced tardive dyskinesia

CD000208.PUB2 (current) · 5 questions

Outcome	Effect	Evidence	Status / GRADE
Tardive dyskinesia: No clinically important improvement ANXIOLYTIC ‐ BUSPIRONE vs PLACEBO	RR 0.53 [0.33, 0.84]	1 study · 42 participants	Low Downgraded: risk of bias
Tardive dyskinesia: Deterioration of symptoms ‐ not reported ANXIOLYTIC ‐ BUSPIRONE vs PLACEBO	no estimate extracted	NR	No studies
Adverse effects ‐ not reported ANXIOLYTIC ‐ BUSPIRONE vs PLACEBO	no estimate extracted	NR	No studies
Acceptability of treatment (measured by participants leaving the study early) ANXIOLYTIC ‐ BUSPIRONE vs PLACEBO	no estimate extracted	1 study · 42 participants	Very low Downgraded: risk of bias
Social confidence, social inclusion, social networks, or personalised quality of life ‐ not reported ANXIOLYTIC ‐ BUSPIRONE vs PLACEBO	no estimate extracted	NR	No studies

ENZYME INHIBITOR ‐ VMAT2‐INHIBITOR (valbenazine) versus PLACEBO for antipsychotic‐induced tardive dyskinesia

Population: 18 to 85 year‐old patients with schizophrenia, schizoaffective disorder, mood disorder, or gastrointestinal disorder + antipsychotic‐induced tardive dyskinesia

CD000208.PUB2 (current) · 3 questions

Outcome	Effect	Evidence	Status / GRADE
Tardive dyskinesia: 1. No clinically important improvement ENZYME INHIBITOR ‐ VMAT2‐INHIBITOR (valbenazine) vs PLACEBO	RR 0.63 [0.46, 0.86]	1 study · 92 participants	Moderate Downgraded: imprecision
Adverse effects ‐ any adverse effect ENZYME INHIBITOR ‐ VMAT2‐INHIBITOR (valbenazine) vs PLACEBO	RR 1.5 [0.92, 2.45]	1 study · 100 participants	Low Downgraded: imprecision
Leaving the study early ENZYME INHIBITOR ‐ VMAT2‐INHIBITOR (valbenazine) vs PLACEBO	RR 1 [0.31, 3.25]	1 study · 102 participants	Very low Downgraded: imprecision, indirectness

FATTY ACID ‐ ETHYL‐EPA versus PLACEBO for antipsychotic‐induced tardive dyskinesia

Population: female and male 42 (mean) years old patients with schizophrenia or schizoaffective disorder and antipsychotic‐induced tardive dyskinesia

CD000208.PUB2 (current) · 7 questions

Outcome	Effect	Evidence	Status / GRADE
Tardive dyskinesia: No clinically important improvement ‐ not reported FATTY ACID ‐ ETHYL‐EPA vs PLACEBO	no estimate extracted	NR	No studies
Tardive dyskinesia: Deterioration of symptoms ‐ not reported FATTY ACID ‐ ETHYL‐EPA vs PLACEBO	no estimate extracted	NR	No studies
Adverse effects: EPS: parkinsonism measured by average ESRS change scores FATTY ACID ‐ ETHYL‐EPA vs PLACEBO	MD 0.3	1 study · 75 participants	Low Downgraded: risk of bias, imprecision
Adverse effects: EPS: dystonia measured by average ESRS change scores FATTY ACID ‐ ETHYL‐EPA vs PLACEBO	no estimate extracted	1 study · 75 participants	Low Downgraded: risk of bias, imprecision
Adverse effects: EPS: akathisia measured by average ESRS change scores FATTY ACID ‐ ETHYL‐EPA vs PLACEBO	no estimate extracted	1 study · 75 participants	Very low Downgraded: risk of bias, imprecision
Acceptability of treatment (measured by participants leaving the study early) FATTY ACID ‐ ETHYL‐EPA vs PLACEBO	RR 0	1 study · 84 participants	Very low Downgraded: risk of bias, imprecision, indirectness
Social confidence, social inclusion, social networks, or personalised quality of life ‐ not reported FATTY ACID ‐ ETHYL‐EPA vs PLACEBO	no estimate extracted	NR	No studies

HERB ‐ GINKGO BILOBA versus PLACEBO for antipsychotic‐induced tardive dyskinesia

Population: male 45.2 (mean) years old patients with schizophrenia and antipsychotic‐induced tardive dyskinesia

CD000208.PUB2 (current) · 5 questions

Outcome	Effect	Evidence	Status / GRADE
Tardive dyskinesia: No clinically important improvement HERB ‐ GINKGO BILOBA vs PLACEBO	RR 0.88 [0.81, 0.96]	1 study · 157 participants	Moderate Downgraded: imprecision
Tardive dyskinesia: Deterioration of symptoms ‐ not reported HERB ‐ GINKGO BILOBA vs PLACEBO	no estimate extracted	NR	No studies
Adverse effects ‐ not reported HERB ‐ GINKGO BILOBA vs PLACEBO	no estimate extracted	NR	No studies
Acceptability of treatment (measured by participants leaving the study early) HERB ‐ GINKGO BILOBA vs PLACEBO	RR 0.25 [0.03, 2.22]	1 study · 157 participants	Very low Downgraded: imprecision, indirectness
Social confidence, social inclusion, social networks, or personalised quality of life ‐ not reported HERB ‐ GINKGO BILOBA vs PLACEBO	no estimate extracted	NR	No studies

HORMONE ‐ MELATONIN versus PLACEBO OR NO TREATMENT for antipsychotic‐induced tardive dyskinesia

Population: female and male 28 to 91 years old patients with antipsychotic‐induced tardive dyskinesia

CD000208.PUB2 (current) · 5 questions

Outcome	Effect	Evidence	Status / GRADE
Tardive dyskinesia: No clinically important improvement HORMONE ‐ MELATONIN vs PLACEBO OR NO TREATMENT	RR 0.89 [0.71, 1.12]	2 studies · 32 participants	Low Downgraded: imprecision, inconsistency
Tardive dyskinesia: Deterioration of symptoms HORMONE ‐ MELATONIN vs PLACEBO OR NO TREATMENT	RR 0.22 [0.01, 4.05]	1 study · 19 participants	Low Downgraded: imprecision
Adverse effects HORMONE ‐ MELATONIN vs PLACEBO OR NO TREATMENT	no estimate extracted	3 studies · 54 participants	Low Downgraded: imprecision
Acceptability of treatment (measured by participants leaving the study early) HORMONE ‐ MELATONIN vs PLACEBO OR NO TREATMENT	no estimate extracted	3 studies · 54 participants	Very low Downgraded: imprecision, indirectness
Social confidence, social inclusion, social networks, or personalised quality of life ‐ not reported HORMONE ‐ MELATONIN vs PLACEBO OR NO TREATMENT	no estimate extracted	NR	No studies

POLYPEPTIDE ‐ CERULETIDE versus PLACEBO for antipsychotic‐induced tardive dyskinesia

Population: female and male 55‐59 year old (mean) patients with various psychiatric conditions and antipsychotic‐induced tardive dyskinesia

CD000208.PUB2 (current) · 5 questions

Outcome	Effect	Evidence	Status / GRADE
Tardive dyskinesia: No clinically important improvement ‐ not reported POLYPEPTIDE ‐ CERULETIDE vs PLACEBO	no estimate extracted	NR	No studies
Tardive dyskinesia: Deterioration of symptoms POLYPEPTIDE ‐ CERULETIDE vs PLACEBO	RR 0.97 [0.14, 6.8]	2 studies · 103 participants	Low Downgraded: risk of bias, imprecision
Adverse effects ‐ any adverse effect POLYPEPTIDE ‐ CERULETIDE vs PLACEBO	RR 1.32 [0.74, 2.36]	2 studies · 122 participants	Low Downgraded: risk of bias, imprecision
Acceptability of treatment (measured by participants leaving the study early) POLYPEPTIDE ‐ CERULETIDE vs PLACEBO	RR 1.09 [0.49, 2.4]	1 study · 85 participants	Very low Downgraded: risk of bias, imprecision
Social confidence, social inclusion, social networks, or personalised quality of life ‐ not reported POLYPEPTIDE ‐ CERULETIDE vs PLACEBO	no estimate extracted	NR	No studies

HYPNOSIS or RELAXATION versus TAU for antipsychotic‐induced tardive dyskinesia

Population: female and male 35 (mean) years old patients with schizophrenia and tardive dyskinesia, acute extrapyramidal symptoms, and/or pseudoparkinsonism

CD000208.PUB2 (current) · 5 questions

Outcome	Effect	Evidence	Status / GRADE
Tardive dyskinesia: No clinically important improvement HYPNOSIS or RELAXATION vs TAU	RR 0.45 [0.21, 0.94]	1 study · 15 participants	Very low Downgraded: risk of bias, imprecision
Tardive dyskinesia: Deterioration of symptoms HYPNOSIS or RELAXATION vs TAU	RR 0.18 [0.01, 3.81]	1 study · 15 participants	Very low Downgraded: risk of bias, imprecision
Adverse effects ‐ not reported HYPNOSIS or RELAXATION vs TAU	no estimate extracted	NR	No studies
Acceptability of treatment (measured by participants leaving the study early) HYPNOSIS or RELAXATION vs TAU	no estimate extracted	1 study · 15 participants	Very low Downgraded: risk of bias, imprecision
Social confidence, social inclusion, social networks, or personalised quality of life ‐ not reported HYPNOSIS or RELAXATION vs TAU	no estimate extracted	NR	No studies