title: Extrapyramidal symptoms during treatment of first schizophrenia episode: results from EUFEST.
abstract: The European First Episode Schizophrenia Trial (EUFEST) included first-episode schizophrenia patients, assessing the efficacy of five antipsychotic drugs (haloperidol, amisulpride, olanzapine, quetiapine and ziprasidone) over one year. Baseline frequency of extrapyramidal symptoms (EPS) in this group of patients (n=490) was as follows: parkinsonism 10.8%, akathisia 10.0%, dystonia 1.8%, and dyskinesia 0.6%. The frequency of parkinsonism at baseline was greater in patients with a brief prior exposure to antipsychotics (≤2 weeks) compared with antipsychotic-naïve ones, and was positively correlated with the intensity of negative symptoms and negatively with depressive symptoms. After one month of treatment, the increase of parkinsonism was highest in patients receiving haloperidol (+13%), that of akathisia in patients treated with ziprasidone (+14%), and 10.1% of the patients were taking anticholinergic drugs, most frequently in the haloperidol group (24%). In 291 patients remaining on treatment after one year, both parkinsonism and akathisia had decreased: the frequency of parkinsonism was 3%, highest in the haloperidol group (9.1%), that of akathisia was 3%, highest in the quetiapine group (7.5%), and 4% of patients were taking anticholinergic drugs, most frequently those receiving haloperidol (10.5%). The results obtained suggest that in first-episode schizophrenia patients during the first year of antipsychotic treatment (in this case amisulpride, haloperidol in low doses, olanzapine, quetiapine and ziprasidone), EPS were present as manageable clinical problems.
authors.affiliation: Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland. Electronic address: janusz.rybakowski@gmail.com.
authors.forename: Janusz K
authors.initials: JK
authors.lastname: Rybakowski
authors.affiliation: University Psychiatric Centre KU Leuven, Campus UC St Joseph Kortenberg, Leuven, Belgium.
authors.forename: Kristof
authors.initials: K
authors.lastname: Vansteelandt
authors.affiliation: Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Remlinger-Molenda
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Austria.
authors.forename: W Wolfgang
authors.initials: WW
authors.lastname: Fleischhacker
authors.affiliation: Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, UMC Utrecht, The Netherlands.
authors.forename: René S
authors.initials: RS
authors.lastname: Kahn
authors.affiliation: University Psychiatric Centre KU Leuven, Campus UC St Joseph Kortenberg, Leuven, Belgium.
authors.forename: Joseph
authors.initials: J
authors.lastname: Peuskens
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001480:Basal Ganglia Diseases / Q000139:chemically induced* / Q000523:psychology; D003863:Depression; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotics; EUFEST; Extrapyramidal symptoms; First episode; Schizophrenia; Treatment