03. Clozapine for Tardive Dyskinesia?

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For our next Quick Take, let’s look at the question: Might clozapine lower the incidence of tardive dyskinesia? In other words, because it’s less dopaminergic, maybe patients with tardive dyskinesia would have less severe symptoms on clozapine than on other antipsychotics. I’m surprised to discover that this has not been examined directly on many occasions. But now we have a new meta-analysis from the 2018 *Journal of Clinical Psychiatry*, where Dr. Thierry Mentzel and colleagues from the Netherlands put together 16 different studies. They were able to find patients who had an abnormal involuntary movement scale, like the AIMS, or other scales, like the Simpson Dyskinesia Scale, that had data on abnormal involuntary movements (tardive dyskinesia) both before clozapine was started and after it was started. And what they found is, sure enough, in these 16 studies, clozapine does indeed lower the tardive dyskinesia scores, like on the AIMS, when