Manganese and Niacin in the Treatment of Drug-Induced Dyskinesias

It is well documented that the antipsychotic medications, i.e., the pheno-thiazines and butyrophenones, offer considerable risk of permanent injury to the liver, skin, cornea, bone marrow, heart, and especially to the nervous system. Tardive dyskinesia, a prolonged and sometimes permanent extrapyramidal syndrome, has been reported in up to 50 percent of patients over age 60 who have been treated with neuroleptics for over three years (Crane, 1973). Tardive dyskinesia is differentiated from the immediately occurring extrapyramidal symptoms that accompany phenothiazines by the fact that it occurs after prolonged exposure or after withdrawal of the neuroleptic. Rigidity and akathisia are prominent symptoms of the immediate extrapyramidal syndrome, and dystonias and oculogyric crises are less frequent manifestations. The immediate extrapyramidal syndrome is easily controlled by reducing the dose of neuroleptic or adding an anticholinergic antiparkinson agent to the medication regime. Tardive dyskinesia is dominated by disturbed movements, just as the name