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Clozapine and Tardive Dyskinesia

Jack M. Singer, MD
Arch Gen Psychiatry. 1983;40(3):347. doi:10.1001/archpsyc.1983.01790030117020.
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To the Editor.—  Jeste and Wyatt's recent article (Archives 1982;39:803-816) examining specific treatment approaches to tardive dyskinesia (TD) was a comprehensive review of a rather perplexing topic. The methodologic issues pointed out in clinical trial results to date are noteworthy and certainly confounded the authors' attempt to make reasonable interpretations of a large body of data. Nevertheless, multiple comparisons across drug groups and between drugs were made and subjected to conventional statistical analysis. Only 23% of the published studies reviewed were double-blind, yet those data were combined with data from open studies, and comparisons between neuroleptics were attempted. Although the stated criterion for effectiveness, a 50% improvement in clinical symptoms, may represent a clinically meaningful change, patients with complete remissions were not specifically identified. Changes in global severity scores were not distinguished from changes in symptom clusters such as buccolingual or limb dyskinesias. Rating instruments were not described for the


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