Study on risk factors of extrapyramidal symptoms induced by antipsychotics and its correlation with symptoms of schizophrenia

Abstract

BackgroundExtrapyramidal symptoms (EPS) are one of the most common and neglected side effects during the treatment of schizophrenia. The risk factors of EPS in Chinese patients with schizophrenia and its relationship with psychiatric symptoms and mood symptoms of schizophrenia remain unknown.AimsThe main objective of this study is to explore the risk factors of EPS caused by antipsychotics and the relationship between EPS and psychotic symptoms and mood symptoms of schizophrenia.MethodThis study included 679 patients with schizophrenia who have met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. Patients were divided into the EPS group and the non-EPS group according to the scale rating criteria and whether the anticholinergics have been used. The differences between demographic data and characters of drug intake were compared between the two groups, and the risk factors of EPS were selected between those factors. Correlation analysis was performed on the severity of schizophrenia (Positive and Negative Symptoms Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS) score) and EPS scale (Simpson-Angus Scale (SAS), Barnes Akathisia Rating Scale (BARS), Abnormal Involuntary Movement Scale (AIMS) score) in 679 patients. The differences between the PANSS subscale score and the CDSS score between the EPS group and the non-EPS group were compared.ResultCompared with the non-EPS group, the EPS group patients are older, and they have a longer duration since first prescribed antipsychotics. The EPS group patients have higher frequency of atypical antipsychotics polytherapy and typical and atypical antipsychotics polytherapy or combined treatments with mood stabilisers. Logistic regression analysis shows that antipsychotics with high D2 receptor antagonistic effect and illness duration are the risk factors of EPS. The SAS score was significantly correlated with PANSS negative score, PANSS general psychopathological score and PANSS total score. The BARS scale score was significantly correlated with PANSS positive score, PANSS general psychopathological score, PANSS total score and CDSS total score. The AIMS scale score was significantly correlated with PANSS negative score. Compared with the non-EPS group, the EPS group patients have significantly higher PANSS negative score, PANSS general psychopathological score, PANSS total score and CDSS total score.ConclusionAntipsychotic drugs with high D2 receptor antagonism and disease duration are risk factors of EPS in Chinese patients with schizophrenia. The severity of various types of EPS is significantly correlated with the psychiatric and mood symptoms of schizophrenia, and psychiatric symptoms and mood symptoms were significantly more severe in the EPS group. The occurrence of EPS is associated with poor treatment outcome of schizophrenia.

Safety and related factors of treatment with long-term atypical antipsychotic in Chinese patients with schizophrenia: observational study

“…At present, there are articles published on the analysis of the data in this study, and a pharmacodynamic model has been established to quantify the time-efficacy relationship of antipsychotic drugs. [31][32][33] Contributors WY and SH are responsible for the project implementation and the writing of the paper. JH is responsible for the project implementation and ethical review.…”

Psychotropic medications induced parkinsonism and akathisia in people attending follow-up treatment at Jimma Medical Center, Psychiatry Clinic

“…Patients taking sodium valproate were 1.88 times more likely to develop akathisia than those taking antipsychotics only; however study done by Weng J et al . did not find out any statistically significant difference in extra-pyramidal symptoms between the two groups of patients [ 39 ].…”

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“…Los síntomas extrapiramidales agudos tempranos se desarrollan con mayor frecuencia al comienzo del tratamiento con antipsicóticos o cuando se aumenta la dosis, mientras que los de inicio tardío suelen ocurrir después de un tratamiento prolongado y se presentan como discinesia tardía. Los síntomas extrapiramidales agudos son una de las principales causas de mala adherencia al tratamiento antipsicótico por la reversibilidad de los síntomas, mientras que la discinesia tardía es la que más afecta la calidad de vida de pacientes y cuidadores 23,24 .…”