Some studies suggest vitamin E may help ease symptoms of tardive dyskinesia — but how strong is the evidence, and what does it really tell us?
Note: The U.S. Food and Drug Administration (FDA) does not approve supplements for safety or effectiveness. Talk to a healthcare professional about whether a supplement is the right fit for your individual health, and about any potential drug interactions or safety concerns.
If you’re living with tardive dyskinesia, you’ve likely explored several avenues for relief, from adjusting medications to trying new treatments.
Tardive dyskinesia is a movement disorder marked by repetitive, involuntary motions — such as lip smacking, facial grimacing, or jerking of the limbs — that typically develops after long-term use of antipsychotic medications.
What if relief could come from something as simple and accessible as a vitamin supplement?
Vitamin E, known for its antioxidant properties, has been studied for decades for its potential to help with tardive dyskinesia. Early research offered some hope that this nutrient protects nerve cells and eases involuntary movements, making it a low-risk, promising option. However, findings have been inconsistent over time.
Today, the evidence is mixed, and experts remain uncertain about how effective vitamin E is for tardive dyskinesia.
To help clarify the picture, let’s look at five notable studies — highlighting where vitamin E may offer support, where it may fall short, and what questions remain.
Study 1. Landmark Trial Finds No Benefit From Vitamin E
Early excitement about vitamin E as a treatment for tardive dyskinesia faded when a large, rigorous clinical trial failed to back up the encouraging results of earlier, smaller studies. This landmark investigation — the U.S. Department of Veterans Affairs (VA) Cooperative Study, published in 1999 — set out to provide a more definitive answer about whether vitamin E could truly help.
In this prospective, randomized study conducted at nine different sites, 158 veterans with tardive dyskinesia who were taking antipsychotic medications were enrolled. They were randomly assigned to receive either vitamin E at a daily dose of 1,600 IU or a placebo. Unlike prior short-term research, this trial extended treatment for up to two years.
The outcome was clear: Vitamin E did not outperform placebo. No meaningful differences were seen in scores on the Abnormal Involuntary Movement Scale (AIMS) — a standard tool clinicians use to rate the severity of tardive dyskinesia — nor on related subscales or detailed electromechanical movement measures. While vitamin E proved safe and well tolerated, it offered no therapeutic effect.
Researchers attributed the contrast with earlier reports to the study’s larger scale, longer follow-up, and the changing landscape of psychiatric care, such as the wider use of newer antipsychotics. They also suggested that, while vitamin E’s antioxidant properties might help prevent damage, once tardive dyskinesia is established, antioxidant therapy alone may be insufficient to reverse it.
Study 2. Over 70 Percent Symptom Improvement in 90 Days
A case series published in European Psychiatry described four adults whose tardive dyskinesia symptoms improved while taking vitamin E.
All four people were hospitalized with serious mental illness and had a history of long-term antipsychotic use. They each received 1,600 IU of vitamin E daily. After 90 days, their AIMS scores had improved between 72 and 80 percent.
Larger studies are needed to determine whether vitamin E can reliably improve tardive dyskinesia symptoms. However, early case studies show benefits, and the researchers say this supplement can be used with a low risk of side effects.
Study 3. Vitamin E May Target Underlying Pathways Linked to Tardive Dyskinesia
Vitamin E appears to help regulate a key cell signaling pathway involved in tardive dyskinesia, according to a recent multilevel analysis published in Schizophrenia. The nutrient helps by reducing oxidative stress, neuroinflammation, and cell death.
Researchers used data mining to compare the mechanisms of action of two tardive dyskinesia medications, valbenazine (Ingrezza) and deutetrabenazine (Austedo), with those of vitamin E. They analyzed interactions between each compound and pathways related to tardive dyskinesia and checked how well each compound binds to target proteins.
The study found that vitamin E acts in distinct ways compared with valbenazine and deutetrabenazine. It might influence five different chemicals along PI3K-Akt, a cell-signaling pathway involved in tardive dyskinesia.
The researchers say vitamin E could stop tardive dyskinesia symptoms from intensifying by curbing oxidative damage, modulating immune responses, and reducing neuroinflammation. It may also keep the membranes of nerve cells healthy and scavenge free radicals to reduce damage to nerve cells.
Study 4. Vitamin E Can Protect Against Worsening Tardive Dyskinesia
A systematic review of studies published in The Canadian Journal of Psychiatry gave vitamin E a Grade B recommendation for tardive dyskinesia — suggesting that, while it may not improve the condition once established, vitamin E could protect against worsening symptoms.
The authors’ recommendation was based on 11 studies published between 1990 and 1999, involving a total of 427 participants, with an average age of 50 years. Participants took vitamin E for periods ranging from two weeks to 12 months, at doses between 600 IU and 1,600 IU.
There was no difference between vitamin E and placebo for improving tardive dyskinesia symptoms. However, people who took placebos had a 61 percent higher risk of worsening tardive dyskinesia symptoms compared with those taking vitamin E.
Study 5. No Difference Between Vitamin E and Placebo
A Cochrane review published in 2018 found no difference in tardive dyskinesia symptoms between vitamin E and placebo. This review included 13 studies from July 2015 through April 2017, including 478 participants.
While vitamin E didn’t improve tardive dyskinesia symptoms compared with placebo, it also didn’t cause more side effects or make patients less willing to continue treatment. Researchers say the evidence is of low quality, however, and more large studies are needed.
“New and better trials are indicated in this under‐researched area, and, of the many adjunctive treatments that have been given for TD [tardive dyskinesia], vitamin E would be a good choice for further evaluation,” the researchers noted.
Why We Need More Research on Vitamin E and Tardive Dyskinesia
Research on vitamin E and tardive dyskinesia shows mixed results, which may disappoint considering how limited the treatment options are for this disruptive condition. Here are some reasons the results might conflict, and why more research is still necessary.
- We need larger studies to parse out who is most likely to benefit. A meta-analysis suggests that fewer than a thousand people have participated in placebo-controlled trials testing vitamin E for tardive dyskinesia. Larger studies with more ethnically and racially diverse populations could offer new insights into who, exactly, benefits from vitamin E, and who doesn’t.
Another individual factor that might influence outcomes is overall health. A Nature analysis of clinical trials suggests that people who are otherwise healthy benefit less from vitamin E supplements than those with preexisting conditions. One possible explanation is that individuals with high levels of inflammation may benefit more from an antioxidant supplement than those who are already managing their inflammation effectively.
Finally, genetic research also suggests that gene variants can influence vitamin E metabolism. Understanding the genetic and biochemical factors that make some people more likely to benefit from vitamin E could advance personalized treatment approaches in the future.
- We don’t know the best vitamin E dose, form, or duration. These can all affect results, according to a review of studies from 1981 through August 2005. The trials to date have used a wide range of vitamin E doses and formulations, and patients have taken the supplements for varying amounts of time.
While a dose too small might not show noticeable effects, excess vitamin E can actually worsen inflammation, research suggests. More importantly, because this vitamin is fat-soluble, it’s stored in body fat and the liver rather than flushed out quickly, so high doses can build up to toxic levels.
Potential problems include easy bruising, frequent nosebleeds, nausea, diarrhea, and fatigue. Mayo Clinic also notes that large amounts can interfere with blood-thinning medicines such as warfarin (Coumadin). At very high levels, vitamin E can disrupt vitamin K–dependent clotting factors and increase the risk of a hemorrhagic stroke. For these reasons, experts advise taking vitamin E supplements only under a doctor’s supervision.
For adults, the recommended daily amount of vitamin E is about 15 milligrams (22 IU), and most supplements contain much more, per Cleveland Clinic. In most cases, you can meet your needs through food sources such as olive oil, nuts and seeds, dairy products, meats, and leafy greens — especially if the diet includes a variety of these foods.
Form matters, too. Vitamin E comes in eight forms, all of which have varying levels of biological activity, according to the National Institutes of Health Office of Dietary Supplements. Finally, the duration of the intervention matters too. Most studies involved taking supplements for less than five months, according to the Cochrane Library. Since tardive dyskinesia is a chronic condition that can fluctuate in severity over time, we need more information about long-term supplementation, or at least long-term outcomes after short-term supplementation.
Editorial Sources and Fact-Checking
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