From the Research
Vitamin E may be considered as an adjunctive therapy for tardive dyskinesia, particularly in patients who cannot access or tolerate FDA-approved VMAT2 inhibitors, as it shows modest evidence of reducing abnormal movements, although it is not a first-line treatment. The most recent and highest quality study, a meta-analysis published in 2022 1, found that vitamin E treatment resulted in a significant decrease in the Abnormal Involuntary Movements Scale (AIMS) scores, indicating a potential benefit in reducing symptoms of tardive dyskinesia. However, the evidence is not strong enough to support its use as a primary treatment, and FDA-approved VMAT2 inhibitors (valbenazine or deutetrabenazine) should be considered first due to stronger evidence of efficacy.
Some key points to consider when using vitamin E for tardive dyskinesia include:
- High-dose vitamin E (1,200-1,600 IU daily) may be necessary to achieve therapeutic effects, as suggested by a study published in 1998 2
- Treatment duration of at least 4-6 weeks is typically needed to assess efficacy, and some patients may require several months of therapy to see maximum benefit
- Vitamin E is generally well-tolerated with minimal side effects at therapeutic doses, though there are concerns about increased bleeding risk at high doses, particularly in patients taking anticoagulants
- The proposed mechanism involves vitamin E's antioxidant properties, which may help neutralize free radicals that contribute to neuronal damage in tardive dyskinesia
It is essential to note that the evidence for vitamin E in treating tardive dyskinesia is not strong, and more research is needed to fully understand its effects. A systematic review published in 2018 3 found that vitamin E may protect against deterioration of tardive dyskinesia, but there is no evidence that it improves symptoms of the condition once established. Therefore, vitamin E should be used with caution and under the guidance of a healthcare professional.