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Vitamin E Treatment for Tardive Dyskinesia
Lenard A. Adler, MD;
John Rotrosen, MD;
Robert Edson, MA;
Philip Lavori, PhD;
James Lohr, MD;
Robert Hitzemann, PhD;
Dennis Raisch, RPh, PhD;
Michael Caligiuri, PhD;
Kathlene Tracy, MA;
and the Veterans Affairs Cooperative Study #394 Study Group
Arch Gen Psychiatry. 1999;56:836-841.
Background Several short-term, controlled trials have documented the efficacy of vitamin E in treating tardive dyskinesia. However, the persistent nature of the disease prompted us to perform a multicenter, longer-term trial of vitamin E.
Methods The study was a prospective, randomized, 9-site trial of up to 2 years of treatment with d-vitamin E (1600 IU/d) vs matching placebo. One hundred fifty-eight subjects with tardive dyskinesia who were receiving neuroleptic medications were enrolled. The blinded assessments performed were clinical (Abnormal Involuntary Movements Scale, Barnes Akathisia Scale, and Modified Simpson-Angus [for Extrapyramidal Symptoms] Scale) and electromechanical assessments of movement disorders, psychiatric status (Brief Psychiatric Rating Scale), and functioning (Global Assessment of Functioning). There were no significant differences in baseline demographic characteristics or in study assessments between the group that received vitamin E and the group that received placebo.
Results Vitamin E was well tolerated and subject compliance with medication was good and similar between treatment groups. One hundred seven subjects (70% of those receiving vitamin E and 66% of subjects receiving placebo) completed at least 1 year of treatment. There were no significant effects of vitamin E on total scores or subscale scores for the AIMS, electromechanical measures of dyskinesia, or scores from the other 4 scales.
Conclusion This long-term, randomized trial of vitamin E vs placebo found no evidence for efficacy of vitamin E in the treatment of tardive dyskinesia.
From the Psychiatry Service, New York Department of Veterans Affairs Medical Center, and Department of Psychiatry, New York University School of Medicine, New York (Drs Adler and Rotrosen and Ms Tracy); Cooperative Studies Program Coordinating Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif (Mr Edson and Dr Lavori); Division of Biostatistics, Stanford University, Stanford, Calif (Dr Lavori); Psychiatry Service, San Diego Department of Veterans Affairs Medical Center, and Department of Psychiatry, University of California, San Diego (Drs Lohr and Caligiuri); Psychiatry Service, Northport, New York Department of Veterans Affairs Medical Center, and Department of Psychiatry, SUNY at Stony Brook, Stony Brook, NY (Dr Hitzemann); Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, Department of Veterans Affairs Medical Center, Albuquerque, NM (Dr Raisch).
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