Treatment of tardive dystonia

Abstract

Treatment options for tardive dystonia (TDyst) consist primarily of botulinum toxin (BTX) injections, medications, and deep brain stimulation (DBS). When most of the disability is caused by a small number of muscles, BTX should be used first. If BTX injections are not sufficient, medications should be tried. Although dopamine depletors such as reserpine and tetrabenazine are the most effective medications for TDyst, they can produce depression and other side effects and should be used only if at least one other medication fails. Medications for idiopathic dystonia (anticholinergics, baclofen, and clonazepam) sometimes produce significant benefit for TDyst. Medications used for other tardive syndromes may help TDyst but are much less likely to be of benefit, and some patients will require DBS of the globus pallidus.