To look at the effects of pyridoxal 5 phosphate in the treatment of the
movement disorder tardive dyskinesia, which is caused by long term use
of antipsychotic drugs in people with schizophrenia.
The main treatment for schizophrenia is antipsychotic drugs. However,
these drugs sometimes have severe and disabling side effects. Tardive
dyskinesia is a movement disorder that causes the muscles of the face,
neck, tongue and limbs to twitch. It can be caused by taking
antipsychotic drugs over a long period of time. It often results in
stigma, low quality of life and can lead to people stopping their
antipsychotic medication. While there are no known treatments for
tardive dyskinesia, some reports suggest that pyridoxal 5 phosphate may
reduce tardive dyskinesia.
A search for relevant randomised studies was conducted in January 2013.
The review includes three studies with 80 participants. All participants
had tardive dyskinesia as a result of taking antipsychotic medication
and were randomised into treatment groups. One group received pyridoxal
5 phosphate, the other group received a placebo. Antipsychotic treatment
continued as usual throughout the trials.
People taking pyridoxal 5 phosphate in these studies experienced more
than 40% improvement in their tardive dyskinesia compared to those on
placebo, so had less severe tardive dyskinesia. Experience of side
effects were similar between treatment groups with participants taking
pyridoxal 5 phosphate experiencing no more or less side effects than
participants in the placebo group and they did not experience greater
worsening of their psychiatric symptoms than those on placebo. Evidence
from the studies is weak, but suggests pyridoxal 5 phosphate may be
effective in the treatment of tardive dyskinesia.
Quality of the evidence.
Evidence is weak. The number of studies and participants is few. The
quality of studies is low. Better evidence could be gathered by better
designed, conducted and reported trials.
Adelufosi, A.O.; Abayomi, O.; Ojo, T.M.F. Pyridoxal 5 phosphate for neuroleptic-induced tardive dyskinesia. Cochrane Database of Systematic Reviews (2015) Issue 4, Art. No.: CD010501. [DOI: 10.1002/14651858.CD010501.pub2]
Pyridoxal 5 phosphate for neuroleptic-induced tardive dyskinesia