Prevalence and risk factors for tardive dyskinesia: a study in an Italian population of chronic schizophrenics

Abstract

The aim of this study was to evaluate tardive dyskinesia (TD) (prevalence and possible risk factors, pharmacological and clinical), in a population of schizophrenic patients after prolonged institutionalization. A total of 148 patients (80 male, 68 female) aged between 28 and 87 years (mean 55, SD 11) diagnosed according to DSM III were included in the study and assessed for the presence and severity of TD using the Abbreviated Rockland Simpson Scale for TD. Of the examined population, 32% were found to be affected by TD. Patients over 55 years had a relative risk of TD that was 2.3 times higher than in subjects under 55 (P less than 0.05). The most frequent movements were orofacial (60%) and in the extremities (56.4%). No significant relationship between duration of neuroleptic treatments, illness or hospitalization, anticholinergic drugs and TD prevalence was found. Severity was related to age, since there was a positive linear relationship between age and Simpson Scale scores (r = 0.45, P less than 0.01).

Tardive Dyskinesia Outcomes: Clinical and Pharmacologic Correlates of Remission and Persistence

“…In fact, after statistical analysis of the duration of treatment as a covariate, its significance is reduced, but not lost. If we consider this finding along with that of no significant difference found in NL cu mulative doses at the frrst evaluation (Altamura et al 1990) (diff erence was at the p = 0.08 level) 3 years ago, we can hypothesize that a threshold of quantitative ex posure to NL was overcome in several patients during these 3 years, with the concomitant weight of a time dependent variable (increased duration of treatment to gether with aging of neurologic substratum).…”

“…Initially 148 patients were admitted to the study for the fIrst observation (Altamura et al 1990); however, the population available for both observations, thereby fulfilling the aim of the study, was reduced to 125 pa tients (70 males and 55 females with a mean age of 57.8 years) because 23 patients died. To be included, patients had to be diagnosed as suffering from chronic schizo phrenia or a schizoaffective disorder, and to have been treated with NL drugs for at least 3 months prior to en try into the study.…”

Neurobiological mechanisms associated with antipsychotic drug-induced dystonia

“…Blocking muscarinic receptors non-selectively with anticholinergic drugs (Bolden et al, 1992) is common procedure in the treatment of antipsychotic drug-induced dystonia (Simon et al, 2017; Van Harten et al, 1999). Concomitant (prophylactic) anticholinergic treatment of extrapyramidal side effects is, however, also considered to be one of the risk factors for tardive dyskinesia (Jankelowitz, 2013), although Altamura et al (1990) did not find a significant association between anticholinergic drug use and the prevalence of tardive dyskinesia. On the other hand, some studies suggest an improvement in tardive dyskinesia with the cessation of anticholinergics (Desmarais et al, 2012).…”

Pharmacogenetics of tardive dyskinesia in schizophrenia: The role ofCHRM1andCHRM2muscarinic receptors

“…Blocking these muscarinic receptors non-selectively with anticholinergic drugs such as trihexyphenidyl (Cyclodol) (Bolden et al 1992) is common procedure in the treatment of antipsychotic drug-induced parkinsonism and dystonia. Concomitant (prophylactic) anticholinergic treatment of EPSs is, however, considered to be one of the risk factors for TD (Jankelowitz 2013), although Altamura et al (1990) did not find a significant association between anticholinergic drug use and the prevalence of TD. On the other hand, some studies suggest an improvement in TD with the cessation of anticholinergics (Desmarais et al 2012).…”