Kindling: a model for the development of tardive dyskinesia?
Tardive dyskinesia (TD) from long-term neuroleptic treatment may be irreversible; therefore prevention has become a major concern. A controversial issue with regard to the clinical use of neuroleptic drugs is the possible influence on the development of TD of drug holidays. The major characteristics of kindling, theories of TD and the role of multiplicity in the development of TD are described. Some clinical studies point to interruption of neuroleptic therapy being a risk factor for development of irreversible TD. Induction of dyskinesia in non-human primates has been demonstrated after repeated administration of haloperidol. Rodent studies have not been conclusive. Several experimental results link TD with kindling: both conditions involve repeated stimulations, both seem to involve increased receptor responsiveness and in both conditions does depression in GABA transmission in SNR (substantia nigra; pars reticulata) play an important role. It is concluded that the kindling hypothesis is relevant to the investigation of TD.
Department of Psychiatry, Rigshospitalet, DK-2100 Copenhagen, Denmark.
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Glenthøj
Department of Psychiatry, Copenhagen Municipal Bispebjerg Hospital.
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Hemmingsen
Department of Psychiatry, Rigshospitalet, DK-2100 Copenhagen, Denmark.
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Bolwig