Extrapyramidal side-effects of antipsychotics in a randomised trial.
BACKGROUND
There are claims that second-generation antipsychotics produce fewer extrapyramidal side-effects (EPS) compared with first-generation drugs.


OBJECTIVE
To compare the incidence of treatment-emergent EPS between second-generation antipsychotics and perphenazine in people with schizophrenia.


METHODS
Incidence analyses integrated data from standardised rating scales and documented use of concomitant medication or treatment discontinuation for EPS events. Mixed model analyses of change in rating scales from baseline were also conducted.


RESULTS
There were no significant differences in incidence or change in rating scales for parkinsonism, dystonia, akathisia or tardive dyskinesia when comparing second-generation antipsychotics with perphenazine or comparing between second-generation antipsychotics. Secondary analyses revealed greater rates of concomitant antiparkinsonism medication among individuals on risperidone and lower rates among individuals on quetiapine, and lower rates of discontinuation because of parkinsonism among people on quetiapine and ziprasidone. There was a trend for a greater likelihood of concomitant medication for akathisia among individuals on risperidone and perphenazine.


CONCLUSIONS
The incidence of treatment-emergent EPS and change in EPS ratings indicated that there are no significant differences between second-generation antipsychotics and perphenazine or between second-generation antipsychotics in people with schizophrenia.
Miller
Del D
DD
University of Iowa Carver College of Medicine, Iowa City, IA 52242-1000, USA. del-miller@uiowa.edu
Caroff
Stanley N
SN
Davis
Sonia M
SM
Rosenheck
Robert A
RA
McEvoy
Joseph P
JP
Saltz
Bruce L
BL
Riggio
Silvana
S
Chakos
Miranda H
MH
Swartz
Marvin S
MS
Keefe
Richard S E
RS
Stroup
T Scott
TS
Lieberman
Jeffrey A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001480:Basal Ganglia Diseases / Q000139:chemically induced*; D004311:Double-Blind Method; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D012559:Schizophrenia / Q000188:drug therapy*; D055815:Young Adult
D014150:Antipsychotic Agents