Tardive dyskinesia: a 3-year follow-up study

Abstract

SynopsisA prospective study of tardive dyskinesia was carried out to gain information regarding the natural history of the condition and to identify risk factors. Out of an original cohort of 182 psychiatric patients receiving maintenance antipsychotic drugs 99 were available for reassessment after 3 years. In this follow-up group the point prevalence of oro-facial dyskinesia increased from 39% to 47% over the 3-year period. Twenty-two patients developed the disorder, while remission occurred in 14 others. Risk factors predicting the presence of oro-facial dyskinesia at follow-up included being over 50 years of age and the presence of akathisia. There was no convincing association between the duration of antipsychotic drug treatment and the presence or severity of oro-facial dyskinesia. Patients receiving over 1000mg chlorpromazine equivalents of antipsychotic drug per day were unlikely to have the condition. The amount of purposeless trunk and limb movement present proved to be a relatively stable phenomenon, showing only a slight increase with age and no change over the follow-up period. The implications of these findings are discussed, with particular consideration being given to the effects of loss of patients to follow-up.

Atypical Antipsychotics: CATIE Study, Drug-Induced Movement Disorder and Resulting Iatrogenic Psychiatric-Like Symptoms, Supersensitivity Rebound Psychosis and Withdrawal Discontinuation Syndromes

“…When corrected for remissions, the mean annual incidence rate decreased to 2.9%. This incidence rate, which includes both patients who developed and remitted from TD over time, is similar to results found by other studies during the same time period [28, 29]. The cumulative incidence of treatment-emergent TD in the study by Kane et al [29] was 12% after 4 years and 40% after 8 years of neuroleptic exposure, which is similar to our finding of an annual incidence rate (corrected for remissions) of 3% for classical antipsychotics.…”

Tardive dyskinesia in a chronically institutionalized population of elderly schizophrenic patients: prevalence and association with cognitive impairment

“…Evidence favoring topographical subsyndromes has been derived in part from the results of multivariate statistical analysis (Kidger et al, 1980) and from observations of dierential responses to pharmacological interventions (Greil et al, 1985). In addition, and in agreement with the results of the present study, Barnes et al (1983) found that the severity of orofacial but not limb/truncal TD was positively associated with age. Similarly, an association has been noted between both the negative symptoms and the cognitive de®cits of schizophrenia and the orofacial, but not limb/truncal manifestations of TD (Waddington et al, 1987).…”

Blind, controlled, long-term study of the comparative incidence of treatment-emergent tardive dyskinesia with olanzapine or haloperidol

“…Validating the present study's design and choice of subjects, the use of this definition of treatment-emergent tardive dyskinesia revealed a 4.6% incidence of new cases among haloperidol-treated subjects, a rate remarkably consistent with predicted exposure-adjusted treatment-emergent tardive dyskinesia rates for conventional neuroleptic drugs reported in the literature (20). The annual rate of new cases per year, in similar at-risk patients, has been estimated at approximately 5% in several analyses (3,(21)(22)(23). It is not clear whether the incidence of treatment-emergent tardive dyskinesia is linear over a 12-month period, but, if it is, the annualized haloperidol incidence here approaches 8%.…”