Objective: To undertake a selective review of the epidemiology, etiology, and treatment of tardive dyskinesia (TD), with emphasis on the potential influence of estrogen in its expression.
Method: Both Medline and Psycinfo databases were used to search for articles with the following key words: tardive dyskinesia, humans, animals, dopamine, estrogen, estrogen replacement therapy, antioxidants and oxidative stress.
Results: The studies reviewed here suggest that estrogen modulates dopamine-mediated behaviours and that it protects against oxidative stress-induced cell damage caused by long-term exposure to antipsychotic medication.
Conclusions: Estrogen's multimodal role in the central nervous system may prove useful for the amelioration or prevention of TD. All the evidence suggests that a placebo-controlled, randomized trial with safer forms of estrogen should be conducted in postmenopausal women with TD.