Objective: To examine the tolerability and effectiveness of propranolol in treating tardive dyskinesia (TD).

Background: TD is a disabling, often irreversible, movement disorder that results from chronic therapy with dopamine receptor blocking drugs. There are currently no approved treatments. Propranolol, a β-adrenergic blocker, was FDA-approved in 1967 for cardiovascular disease and is used in several other disorders. In the 1980s, several case reports, series, and one small blinded trial demonstrated that over 60% of patients had notable response with low doses. In 2013, we reported a small case series that demonstrated similar response. Propranolol has been a standard early line therapy for TD in the Emory movement disorder clinic. The purpose of this study was to analyze the effect in a larger cohort.

Methods: Database search of Emory movement disorder clinic for TD patients treated with propranolol followed by record review.

Results: 48 patients were analyzed, mean age 63 years, duration of neuroleptic therapy before TD 78 months and duration of TD at the time propranolol was initiated 17 months. Severity of TD was based on a 0-3 scale (0=none, 1=mild, 2=moderate, 3 =severe). Mean severity 2.2. Response was based on a 0-3 scale (0=no response, 1= mild, 2=moderate, 3= significant or complete response). 62% responded to propranolol (mean response score 1.3) and 77% of those had a moderate to significant response. Mean daily dose was 69 mg and duration of therapy 14 months. Three stopped the medication due to adverse effects: two with hypotension and one with nightmares. Analysis of variance was used to find predictors of response, dose and duration of propranolol showed trends.

Conclusions: Propranolol, at low doses, appears to be well tolerated and effective in treating TD for a majority of patients at a magnitude similar to that reported 30 years ago. A prospective randomized trial is warranted.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/propranolol-therapy-for-tardive-dyskinesia-a-retrospective-examination/