Incidence and risk factors for severe tardive dyskinesia in older patients

Severe tardive dyskinesia (TD) represents a serious and potentially disabling movement disorder, yet relatively little is known about the incidence of and risk factors for severe TD. We report the results of a longitudinal prospective incidence study of severe TD in 378 middle-aged and elderly neuro...

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Bibliographic Details
Published in:British journal of psychiatry 1997-08, Vol.171 (2), p.148-153
Main Authors: Caligiuri, Michael P., Lacro, Jonathan P., Rockwell, Enid, McAdams, Lou Ann, Jeste, Dilip V.
Format: Article
Language:English
Subjects:
Age
Aged
Alzheimer's disease
Antipsychotic Agents - adverse effects
Antipsychotics
California - epidemiology
Dyskinesia
Dyskinesia, Drug-Induced - epidemiology
Dyskinesia, Drug-Induced - etiology
Female
Humans
Incidence
Longitudinal Studies
Male
Middle Aged
Movement disorders
Patients
Prospective Studies
Psychiatry
Risk Factors
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Summary:Severe tardive dyskinesia (TD) represents a serious and potentially disabling movement disorder, yet relatively little is known about the incidence of and risk factors for severe TD. We report the results of a longitudinal prospective incidence study of severe TD in 378 middle-aged and elderly neuropsychiatric patients. Psychiatric, neuropsychological, pharmacological and motor variables were obtained at intake and at regular intervals for 36 months. The cumulative incidence of severe TD was 2.5% after one year, 12.1% after two years, and 22.9% after three years. Individual univariable Cox regression analyses were conducted to identify demographic, psychiatric, motor and pharmacological predictors of severe TD. Results indicated that higher daily doses of neuroleptics at study entry, greater cumulative amounts of prescribed neuroleptic, and greater severity of worsening negative symptoms were predictive of severe TD. These findings suggest that conventional neuroleptics may be prescribed to older patients only when necessary and at the lowest effective dosage. Additional caution is recommended in patients exhibiting negative symptoms.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.171.2.148