Prevalence of neuroleptic-induced movement disorders: an 8-year follow-up study in chronic schizophrenia inpatients.
BACKGROUND
Atypical antipsychotic drug use by schizophrenia patients in Estonia increased from 32% in 2004 to 61% in 2009.


OBJECTIVE
To assess the prevalence of neuroleptic-induced movement disorders in the Estonian institutionalized population of schizophrenia patients twice over a period of eight years, before and after introduction of atypical antipsychotic drugs using DSM-IV criteria.


METHODS
DSM-IV criteria and specific rating scales were used to evaluate the prevalence of neuroleptic-induced movement disorders among 72 patients who participated in the study in 2009 compared to 99 patients who participated in 2001.


RESULTS
Despite increased use of atypical antipsychotics in the study population (up to 30% from 20%), the proportion of movement disorder-free population remained the same over 8 years - 38.9% in 2001 versus 38.4% in 2009. There were significant intra-individual fluctuations. Use of a typical antipsychotic resulted in an almost seven times higher risk of tardive dyskinesia after 8 years. Doses of antipsychotic drugs had no effect on the severity of neuroleptic-induced movement disorders.


CONCLUSIONS
Unfortunately, in 18% of patients the switch of medication from typical to atypical did not change the overall prevalence of neuroleptic-induced movement disorders in the group. The long-term benefit of atypical antipsychotics requires further research in patients who are treated with antipsychotics for years.
a Madis Parksepp, Department of Psychiatry , University of Tartu , Tartu , Estonia ;
Madis
M
Parksepp
b Ülle Ljubajev, Department of Psychiatry , University of Tartu , Tartu , Estonia ;
Ülle
Ü
Ljubajev
c Karin Täht, Institute of Psychology , University of Tartu , Tartu , Estonia ;
Karin
K
Täht
d Sven Janno, Department of Psychiatry , University of Tartu , Tartu , Estonia.
Sven
S
Janno
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004409:Dyskinesia, Drug-Induced / Q000453:epidemiology*; D004957:Estonia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology
D014150:Antipsychotic Agents
Akathisia; Antipsychotic treatment; Neuroleptic-induced parkinsonism; Schizophrenia; Tardive dyskinesia