Cocaine is a major risk factor for antipsychotic induced akathisia, parkinsonism and dyskinesia.
OBJECTIVE
To assess the relative contribution of different drugs of abuse to extrapyramidal side effects (EPS) of antipsychotic drugs.


METHODS
106 consecutively contacted or admitted male patients in the Psychiatric Center of Surinam (PCS) with schizophrenia or a related disorder were included. Prevalence and severity of EPS were measured with the Unified Parkinson's Disease Rating Scale (UPDRS), the Abnormal Involuntary Movement rating Scale (AIMS), the Barnes Akathisia Rating Scale (BARS) and the Dystonia rating scale. Recent use of cigarettes, cannabis, alcohol, and cocaine were assessed. Standard multiple regression analyses were used to evaluate the relative contribution of above-mentioned drugs of abuse controlled for milligrams haloperidol equivalent a day and use of anticholinergic medication.


RESULTS
Recent cocaine use was significantly associated with severity of dyskinesia (p = 0.001), parkinsonism (p = 0.007), and akathisia (p < 0.001) (n = 106).


CONCLUSIONS
Recent cocaine use is a major risk factor for antipsychotic induced EPS.
Maat
Arija
A
Department of Psychiatry, Academical Medical Center, Amsterdam, The Netherlands.
Fouwels
Annemarie
A
de Haan
Lieuwe
L
D000293:Adolescent; D000328:Adult; D017109:Akathisia, Drug-Induced / Q000209:etiology*; D014150:Antipsychotic Agents / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000150:complications*; D004409:Dyskinesia, Drug-Induced / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000139:chemically induced*; D012044:Regression Analysis; D012307:Risk Factors
D014150:Antipsychotic Agents