Zuclopenthixol, a combined dopamine D1/D2 antagonist, versus haloperidol, a dopamine D2 antagonist, in tardive dyskinesia.

H Lublin, J Gerlach, U Hagert, B Meidahl, C Mølbjerg, V Pedersen, C Rendtorff, E Tolvanen

Sct. Hans Hospital, Department P, Roskilde, Denmark.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 1991 Dec

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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.

Citation

H Lublin, J Gerlach, U Hagert, B Meidahl, C Mølbjerg, V Pedersen, C Rendtorff, E Tolvanen. Zuclopenthixol, a combined dopamine D1/D2 antagonist, versus haloperidol, a dopamine D2 antagonist, in tardive dyskinesia. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology. 1991 Dec;1(4):541-8