מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – New study findings suggest that melatonin could help prevent tardive dyskinesia (TD) symptoms in patients receiving antipsychotic drugs.
"To our knowledge, this is the first study to demonstrate clinically meaningful improvement of TD symptoms with melatonin," study lead author Dr. Eyal Shamir of Abarbanel Mental Health Center in Israel and his colleagues write in the November issue of the Archives of General Psychiatry.
To investigate melatonin as a potential TD treatment, Dr. Shamir and colleagues studied 22 patients with schizophrenia. About half received 10 milligrams of melatonin daily for 6 weeks, followed by another 6 weeks of placebo. The other half were treated with placebo first, followed by melatonin. All patients had a 4-week washout period.
Overall, the study participants exhibited less severe symptoms after they were treated with melatonin than after they were treated with placebo, the investigators report. This finding remained true regardless of whether the patients were first treated with melatonin or the placebo.
In addition, 7 patients showed a more than 3-point reduction in TD symptom severity–a clinically significant improvement. Nine patients had a 30% or greater improvement in their symptoms after melatonin treatment, the report indicates.
"It remains to be studied whether the efficacy of melatonin will further increase with longer treatment or with larger doses of the hormone," the researchers comment.
The exact mechanism of action for melatonin is not known, but Dr. Shamir's team speculates that it may be related to melatonin's antioxidant properties, which have been shown to have a protective effect on nerve cells.
In a related editorial, Dr. William M. Glazer of Massachusetts General Hospital and his colleagues write that melatonin may be suppressing TD symptoms instead of treating them, based on its proposed mechanism of action. They further point out that the 30% or greater reduction in symptom severity reported by Dr. Shamir's group is "relatively weak," considering that a 50% or greater reduction in symptom severity required before a treatment is considered effective.
"From our perspective, the treatment value of melatonin for TD is questionable," the editorialists write.
They add, however, that the hormone should not be ignored. "Although the newer-generation antipsychotic agents may be diminishing the concern about TD, there remain other safety concerns with these agents that might be helped with antioxidants and other 'alternative' therapies," Dr. Glazer's team concludes.
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