Tetrabenazine for Tardive Tremor in Elderly Adults: A Prospective Follow-up Study

Tardive tremor (TT) is a rare neuroleptic-induced tardive syndrome. It is mainly postural and action associated rather than resting tremor without other parkinsonian features and resistant to most therapeutic interventions. Tetrabenazine (TBZ) is a possible option for treating TT. This study aimed to evaluate the efficacy and tolerability of TBZ in elderly patients with TT. Patients (N = 10) received TBZ (25-150 mg/d) for 6 weeks. Five subjects completed the study. Mean TBZ dose at study end was 57.5 +/- 37.3 mg/d. Mean Abnormal Involuntary Movement score was 13.3 +/- 6.6, mean Tremor Scale score was 2.3 +/- 0.9, mean Clinical Global Impression-Change was 3.6 +/- 2.2, and mean Geriatric Depression Score was 5.2 +/- 4.9; all not significantly changed from baseline. Five patients suffered side effects, including depression (n = 3), parkinsonism (n = 2), akathisia (n = 1), and mild stroke (n = 1). This prospective study does not support TBZ treatment for TT in elderly psychiatric patients.