Prevalence of movement disorders in adolescent patients with schizophrenia and in relationship to predominantly atypical antipsychotic treatment.
OBJECTIVE
To examine prevalence of movement disorders (MDs) such as tardive dyskinesia (TD), parkinsonism or akathisia in an adolescent population with schizophrenia and in relationship to predominantly atypical antipsychotic treatment.


METHODS
Ninety-three patients (aged 19.6+/-2.2 years) were ascertained in this cross-sectional/retrospective study. 76 patients (81.7%) received atypical, 10 (10.8%) typical antipsychotics and 7 (7.5%) combinations of atypical/typical antipsychotics. MD symptoms were assessed using Tardive Dyskinesia Rating Scale (TDRS), Abnormal Involuntary Movement Scale (AIMS), Extrapyramidal Symptom Scale (EPS), Barnes Akathisia Scale (BAS).


RESULTS
Movement disorder symptoms were found in 37 patients (39.8%) fulfilling strict/subthreshold criteria for TD (5.4/11.8%), parkinsonism (2.2/25.8%) or akathisia (1.1/11.8%), respectively. Patients treated with typical antipsychotics displayed a significantly higher EPS-score (P=0.036) and a tendency towards a higher BAS-score (P=0.061) compared to patients with atypical antipsychotics. Treatment durations with typical/atypical antipsychotics showed trends towards advantages of atypical antipsychotics with regard to parkinsonism/akathisia symptoms (P=0.061; P=0.054), but not with regard to TD symptoms (P=0.003), possibly due to confounding effects.


CONCLUSIONS
Under treatment with atypical antipsychotics MD symptoms are less prevalent and less pronounced than under typical antipsychotics. We speculate that the finding of relatively high prevalence rates of subthreshold MD symptoms may be, at least partially, explained by previous or combined therapy with typical antipsychotics.
Gebhardt
Stefan
S
Dept. of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Strasse 8, 35033 Marburg, Germany. Stefan.Gebhardt@med.uni-marburg.de
Härtling
Fabian
F
Hanke
Markus
M
Mittendorf
Markus
M
Theisen
Frank M
FM
Wolf-Ostermann
Karin
K
Grant
Phillip
P
Martin
Matthias
M
Fleischhaker
Christian
C
Schulz
Eberhard
E
Remschmidt
Helmut
H
D000293:Adolescent; D017109:Akathisia, Drug-Induced / Q000453:epidemiology*; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004409:Dyskinesia, Drug-Induced / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D009460:Neurologic Examination / Q000187:drug effects; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*
D014150:Antipsychotic Agents