Propranolol therapy for Tardive dyskinesia: A retrospective examination.
OBJECTIVE
To examine the tolerability and effectiveness of propranolol in treating tardive dyskinesia (TD).


BACKGROUND
TD is a disabling, often irreversible, movement disorder that results from chronic therapy with dopamine receptor blocking drugs. There are no treatments currently approved for this disorder. Propranolol, a β-adrenergic blocker, has been reported to alleviate TD in case series and reports.


METHODS
Retrospective database search of the Emory movement disorder clinic for TD patients treated with propranolol. All patients identified with at least one follow-up evaluation had records reviewed and responsiveness assessed. Logistic regression analysis examined for predictors of response.


RESULTS
Forty-seven patients were analyzed, mean age 63 years. Neuroleptics were discontinued in all patients and duration of TD at the time propranolol was initiated 17 months. Mean severity of TD, based on a 0-3 scale (0 = none, 1 = mild, 2 = moderate, 3 = severe) was 2.2. Mean response, based on a 0-3 scale (0 = no response, 1 = mild response, 2 = moderate response, 3 = complete or near-complete response) was 1.4. Propranolol resulted in improvement in 64% and 77% of those had a moderate to complete or near-complete response. Mean daily dose was 69 mg and duration of therapy 14 months. Three patients stopped the propranolol due to adverse effects: hypotension (2), nightmares (1). Severity of TD and duration of propranolol therapy were associated with response.


CONCLUSION
Low dose propranolol appears to be well tolerated and effective in treating TD. A prospective randomized trial is warranted.
['Hatcher-Martin|Jaime M|JM|', 'Armstrong|Karen A|KA|', 'Scorr|Laura M|LM|', 'Factor|Stewart A|SA|']
D000319:Adrenergic beta-Antagonists D000368:Aged D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D008875:Middle Aged D011433:Propranolol D012189:Retrospective Studies D000071057:Tardive Dyskinesia D016896:Treatment Outcome
Propranolol Therapy Tardive dyskinesia Tardive dystonia