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Duration of Treatment Relationships for Involuntary Movements (Tardive Dyskinesia): Concordance Between Cross-sectional, Clinical, and Longitudinal Animal Studies?

John L. Waddington, PhD; Anthony G. Molloy, MSc
Arch Gen Psychiatry. 1986;43(2):191-191. doi:10.1001/archpsyc.1986.01800020101018
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To the Editor.—  The extensive literature on tardive dyskinesia fails to reveal any general relationship between length of exposure to neuroleptics and the likelihood of involuntary movements emerging. This has prompted the proposal that any period of maximum risk for the development of tardive dyskinesia might occur over much briefer exposure than has been generally assumed.1 The recent interesting report from Toenniessen and colleagues2 indicates the first systematic data that might support this proposal. However, the problems created by the cross-sectional nature of such studies, in diagnostically heterogeneous populations, are well known and are recognized by the authors. Prospective studies are to be preferred to answer such important questions, but such studies present profound logistic difficulties.We have been working with an animal model of late-onset orofacial dyskinesia seen in rats receiving prolonged neuroleptic administration.3 These studies have the advantage of being prospective in nature and using

REFERENCES

Kane JM, Smith JM:  Tardive dyskinesia: Prevalence and risk factors, 1959 to 1979 . Arch Gen Psychiatry 1982;;39:473-481.
Toenniessen LM, Casey DE, McFarland BH:  Tardive dyskinesia in the aged: Duration of treatment relationships . Arch Gen Psychiatry 1985;;42:278-284.
Waddington JL, Cross AJ, Gamble SJ, et al:  Spontaneous orofacial dyskinesia and dopaminergic function in rats after six months of neuroleptic treatment . Science 1983;;220:530-532.
Waddington JL, Youssef HA, Molloy AG, et al:  Association of intellectual impairment, negative symptoms and aging with tardive dyskinesia: Clinical and animal studies . J Clin Psychiatry 1985;;46( (pt 4) , sec 2):29-33.
Waddington JL:  Tardive dyskinesia: A critical re-evaluation of the causal role of neuroleptics and of the dopamine receptor supersensitivity hypothesis , in Callaghan N, Galvin R (eds): Recent Research in Neurology . London, Pitman Books Ltd, 1984;, pp 34-48.

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Kane JM, Smith JM:  Tardive dyskinesia: Prevalence and risk factors, 1959 to 1979 . Arch Gen Psychiatry 1982;;39:473-481.
Toenniessen LM, Casey DE, McFarland BH:  Tardive dyskinesia in the aged: Duration of treatment relationships . Arch Gen Psychiatry 1985;;42:278-284.
Waddington JL, Cross AJ, Gamble SJ, et al:  Spontaneous orofacial dyskinesia and dopaminergic function in rats after six months of neuroleptic treatment . Science 1983;;220:530-532.
Waddington JL, Youssef HA, Molloy AG, et al:  Association of intellectual impairment, negative symptoms and aging with tardive dyskinesia: Clinical and animal studies . J Clin Psychiatry 1985;;46( (pt 4) , sec 2):29-33.
Waddington JL:  Tardive dyskinesia: A critical re-evaluation of the causal role of neuroleptics and of the dopamine receptor supersensitivity hypothesis , in Callaghan N, Galvin R (eds): Recent Research in Neurology . London, Pitman Books Ltd, 1984;, pp 34-48.

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