title: Zuclopenthixol, a combined dopamine D1/D2 antagonist, versus haloperidol, a dopamine D2 antagonist, in tardive dyskinesia.
abstract: Animal data suggest that a D1 antagonistic component in neuroleptic drugs counteracts development of dopamine supersensitivity and of tolerance to cataleptic effect. This has led to the hypothesis that neuroleptics with D1 antagonistic activity should cause a better suppression of tardive dyskinesia (TD) and less rebound aggravation after withdrawal than pure D2 antagonists. In this study the effect of zuclopenthixol (mixed D1/D2 antagonist) and haloperidol (D2 antagonist) was evaluated in chronic psychotic patients with TD. Fifteen patients completed a randomized crossover study with blind evaluation of TD and parkinsonism. The test medications, haloperidol and zuclopenthixol, caused a significant suppression of TD and a significant increase of parkinsonism. No significant differences between haloperidol and zuclopenthixol were observed. No TD aggravation was seen. The lack of differences between the mixed D1/D2 antagonist and a D2 antagonist suggest that tolerance and DA supersensitivity play no or a minor role for development of TD.
authors.affiliation: Sct. Hans Hospital, Department P, Roskilde, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Lublin
authors.forename: J
authors.initials: J
authors.lastname: Gerlach
authors.forename: U
authors.initials: U
authors.lastname: Hagert
authors.forename: B
authors.initials: B
authors.lastname: Meidahl
authors.forename: C
authors.initials: C
authors.lastname: Mølbjerg
authors.forename: V
authors.initials: V
authors.lastname: Pedersen
authors.forename: C
authors.initials: C
authors.lastname: Rendtorff
authors.forename: E
authors.initials: E
authors.lastname: Tolvanen
mesh_terms: D000328:Adult; D000368:Aged; D003006:Clopenthixol / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy*; D005260:Female; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010302:Parkinson Disease, Secondary / Q000139:chemically induced; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications
chemical_list: D003006:Clopenthixol; D006220:Haloperidol