title: Cocaine as a risk factor for neuroleptic-induced acute dystonia.
abstract: BACKGROUND
  A prospective study was conducted to test the hypothesis that cocaine use is a risk factor for neuroleptic-induced acute dystonia (NIAD).
  
  
  METHODS
  The study sample consisted of a high-risk group for NIAD, males aged 17-45 years who had received high-potency neuroleptics within 24 hours of admission and had not used neuroleptics in the month prior to admission. Patients were excluded if they suffered from a neurodegenerative disorder or were exposed to anticholinergics, benzodiazepines, promethazine, carbamazepine, phenytoin, or levodopa during the study. Twenty-nine patients--9 cocaine users and 20 nonusers--entered the study, which lasted 2 years. Patients were followed for 7 days.
  
  
  RESULTS
  Cocaine-using psychiatric patients developed significantly more NIAD than did nonusers (relative risk = 4.4, 95% CI = 1.4 to 13.9).
  
  
  CONCLUSIONS
  Cocaine use is a major risk factor for NIAD and should be added to the list of well-known risk factors. The authors strongly suggest that cocaine-using psychiatric patients who are started on a regimen of neuroleptics should also be administered an anticholinergic for at least 7 days to prevent NIAD.
authors.affiliation: Psychiatric Hospital (Dr. D. R. Capriles Clinic), Curaçao, The Netherlands Antilles.
authors.forename: P N
authors.initials: PN
authors.lastname: van Harten
authors.forename: J C
authors.initials: JC
authors.lastname: van Trier
authors.forename: E H
authors.initials: EH
authors.lastname: Horwitz
authors.forename: G E
authors.initials: GE
authors.lastname: Matroos
authors.forename: H W
authors.initials: HW
authors.lastname: Hoek
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D015897:Comorbidity; D004359:Drug Therapy, Combination; D004421:Dystonia / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D009427:Netherlands Antilles / Q000453:epidemiology; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists