Intervention Review

Vitamin E for neuroleptic-induced tardive dyskinesia

  1. Karla Soares-Weiser1,*,
  2. Nicola Maayan1,
  3. John McGrath2

Editorial Group: Cochrane Schizophrenia Group

Published Online: 16 FEB 2011

Assessed as up-to-date: 19 JUL 2010

DOI: 10.1002/14651858.CD000209.pub2

Database Title

Additional Information

How to Cite

Soares-Weiser K, Maayan N, McGrath J. Vitamin E for neuroleptic-induced tardive dyskinesia. Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No.: CD000209. DOI: 10.1002/14651858.CD000209.pub2.

Author Information

  1. 1

    Enhance Reviews Ltd, Wantage, UK

  2. 2

    Queensland Brain Institute, Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia

*Karla Soares-Weiser, Enhance Reviews Ltd, Central Office, Cobweb Buildings, The Lane, Lyford, Wantage, OX12 0EE, UK. karla@enhance-reviews.com. ksoares@netvision.net.il.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 16 FEB 2011

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Antipsychotic (neuroleptic) medication is used extensively to treat people with chronic mental illnesses. Its use, however, is associated with adverse effects, including movement disorders such as tardive dyskinesia (TD) – a problem often seen as repetitive involuntary movements around the mouth and face. Vitamin E has been proposed as a treatment to prevent or decrease TD.

Objectives

To determine the effects of vitamin E for people with schizophrenia or other chronic mental illnesses who also developed neuroleptic-induced TD.

Search methods

We searched the Cochrane Schizophrenia Group Trials Register (March 2010), inspected references of all identified studies for further trials and contacted authors of trials for additional information.

Selection criteria

We included reports if they were controlled trials dealing with people with neuroleptic-induced TD and schizophrenia who had been randomly allocated to either vitamin E or to a placebo or no intervention.

Data collection and analysis

We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who dropped out had no improvement.

Main results

The review now includes 11 poorly reported randomised trials (total 427 people). There was no clear difference between vitamin E and placebo for the outcome of 'clinically relevant improvement in TD' (6 trials, 256 people, RR 0.95 CI 0.89 to 1.02). For the outcome of 'any improvement in TD symptoms', again, we found no clear difference between groups (7 trials, 311 people, RR 0.86 CI 0.75 to 1.00). However, people allocated to placebo showed more deterioration of their symptoms compared with those given vitamin E (5 trials, 98 people, RR 0.38 CI 0.16 to 0.9). There was no difference in the incidence of adverse effects (9 trials, 203 people, RR 1.29 CI 0.51 to 3.24) or leaving the study early (medium term 6 trials, 173 people, RR 1.29 CI 0.72 to 2.3). There is no trial-based information regarding the effect of vitamin E for those with early onset of TD.

Authors' conclusions

Small trials of limited quality suggest that vitamin E may protect against deterioration of TD. There is no evidence that vitamin E improves symptoms of this problematic and disfiguring condition once established. New and better trials are indicated in this under-researched area, and, of the many adjunctive treatments that have been given for TD, vitamin E would be a good choice for further evaluation.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Vitamin E for neuroleptic-induced tardive dyskinesia

Having to take antipsychotic drugs for long periods of time can cause repetitive movements - often of the face and mouth. These are disfiguring and do not necessarily cease once medication is reduced or changed. Vitamin E has been evaluated for treating these movement disorders, but, so far, the benefit of this medication seems small and restricted to avoidance of deterioration.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

維生素E治療抗精神病藥引起的遲發性運動障礙(neurolepticinduced tardive dyskinesia)

抗精神病藥物(antipsychotic medication)被廣泛用於治療慢性精神疾病。然而它也會造成相當程度的副作用，包括運動障礙(如遲發性運動障礙(TD))。有人提出使用維生素E來防止或減少遲發性運動障礙的嚴重程度

目標

確定維生素E對於精神分裂症或其他慢性精神病患者身上出現的遲發性運動障礙的臨床效果

搜尋策略

電子搜索Biological Abstracts (1982 – 2001), The Cochrane Schizophrenia Group's Register (January 2001), EMBASE (1980 – 2001), LILACS (1982 – 2001), MEDLINE (1966 – 2001), PsycLIT (1974 – 2001), SCISEARCH (1997)，手工檢索所有確定研究的參考和每一個包括在內的審查的第一作者接觸

選擇標準

針對精神分裂症或其他慢性精神疾患出現的遲發性運動障礙的對照試驗，而且患者是被隨機分配到接受維生素E或安慰劑或是不做任何處理的研究報告才會被納入做分析

資料收集與分析

每個審查人員獨立地從選取的試驗中擷取資料，並會去計算包含95% confidence intervals (CI)的relative risks (RR) 或是weighted mean differences (WMD)，同時假設中途退出試驗的患者是沒有改善的

主要結論

總共納入了10個研究，其中針對‘臨床相關改善’這個項目上，整體結果顯示維生素E與安慰劑並沒有差異(6個試驗，256人，RR 0.95 CI 0.89到1.02); 至於在‘遲發性運動障礙症狀上的任何改善’這個項目上，同樣地，維生素E與安慰劑也沒有顯示出差異(7試驗，311人，RR 0.86 CI 0.75至1.00)。然而在幾個研究中沒有被分派到維生素E的患者，卻呈現出症狀的惡化(5個試驗，98人，RR 0.38 CI 0.16至0.9)。至於在出現副作用(8 個試驗，163人，RR 130 CI 0.5至3.2)以及提早離開試驗(中期5個試驗，133人，RR 150 CI 0.8至2.7)的比率上則是沒有顯示出差異。此外，維生素E對於早發性(early onset)的遲發性運動障礙的效用則沒有研究案來提供資料

作者結論

小型且不確定隨機品質的試驗顯示，維生素E可防止遲發性運動障礙的惡化，但並沒有證據顯示維生素E可以改善遲發性運動障礙的症狀

翻譯人

本摘要由彰化基督教醫院廖慈凰翻譯

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

長時間使用抗精神病藥物會造成重複性運動障礙，且經常會發生在臉部及嘴部。這會造成外觀不雅，而且當藥物劑量減輕或是換藥時也不必然會停止。維生素E曾被拿來評估使用在這些運動障礙的治療上，但是到目前為止，這個藥物的好處顯得不大而且只侷限於避免症狀的惡化上

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