title: The incidence of tardive dyskinesia in the study of pharmacotherapy for psychotic depression.
abstract: Tardive dyskinesia (TD) is a debilitating adverse effect associated with antipsychotic treatment. Older age and the presence of mood disorder have been identified as risk factors for the development of TD. Thus, we assessed the incidence of TD in younger and older patients with major depressive disorder with psychotic features who participated in a 12-week clinical trial comparing olanzapine plus sertraline versus olanzapine plus placebo. All subjects (n = 259) were assessed with the Abnormal Involuntary Movement Scale at baseline and after 4, 8, and 12 weeks of treatment (or at termination). We used 7 different published criteria to estimate the prevalence of TD at baseline and the incidence over the duration of the trial. We compared the incidence of TD in subjects 60 years or older and those younger than 60 years. The overall prevalence and incidence of TD varied almost 10-fold, depending on the criteria (prevalence range, 1.2%-8.9%; incidence range, 0.0%-5.9%). Tardive dyskinesia was observed as a clinical adverse event in only 1 subject (0.4%). Whereas older subjects had a higher prevalence of TD at baseline, the incidence in younger and older subjects did not differ significantly. The incidence of TD was relatively low in both younger and older patients with major depressive disorder with psychotic features treated acutely with olanzapine. However, the estimate of the risk of TD varies widely, depending on the criteria used to define TD.
authors.affiliation: Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Blumberger
authors.forename: Benoit H
authors.initials: BH
authors.lastname: Mulsant
authors.forename: Dora
authors.initials: D
authors.lastname: Kanellopoulos
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Whyte
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Rothschild
authors.forename: Alastair J
authors.initials: AJ
authors.lastname: Flint
authors.forename: Barnett S
authors.initials: BS
authors.lastname: Meyers
mesh_terms: D000367:Age Factors; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000503:physiopathology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D000077152:Olanzapine; D015995:Prevalence; D011618:Psychotic Disorders / Q000188:drug therapy / Q000503:physiopathology; D012307:Risk Factors; D020280:Sertraline / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine; D020280:Sertraline