Estrogen receptor activation and tardive dyskinesia

Objective: To undertake a selective review of the epidemiology, etiology, a nd treatment of tardive dyskinesia (TD), with emphasis on the potential inf luence of estrogen in its expression. Method: Both Medline and Psycinfo databases were used to search for article s with the following key words: tardive dyskinesia, humans, animals, dopami ne, estrogen, estrogen replacement therapy, antioxidants and oxidative stre ss. 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 p rove useful for the amelioration or prevention of TD. All the evidence sugg ests that a placebo-controlled, randomized trial with safer forms of estrog en should be conducted in postmenopausal women with TD.