Prevalence of and Risk Factors for Extrapyramidal Side Effects of Antipsychotics
Autor: | Thierry d'Amato, Guillaume Fond, Arnaud Tessier, Christophe Lançon, Romain Rey, Ophélia Godin, Wassilios G. Meissner, C. Passerieux, Mathieu Urbach, Jasmina Mallet, Franck Schürhoff, M. Andrianarisoa, Bruno Aouizerate, Laurent Boyer, Pierre-Michel Llorca, A. Schandrin, Delphine Capdevielle, Julien Dubreucq, Caroline Dubertret, Isabelle Chéreau-Boudet, Pierre Vidailhet, David Misdrahi, E. Bulzacka, Catherine Faget-Agius, Fabrice Berna, Antoine Daubigney |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male Dyskinesia Drug-Induced medicine.medical_specialty Medication Therapy Management medicine.drug_class medicine.medical_treatment Tardive dyskinesia law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Risk Factors law Internal medicine Prevalence medicine Anticholinergic Humans Tardive Dyskinesia Parkinson Disease Secondary Antipsychotic Psychiatric Status Rating Scales Positive and Negative Syndrome Scale business.industry Odds ratio medicine.disease 030227 psychiatry 3. Good health Diagnostic and Statistical Manual of Mental Disorders Psychiatry and Mental health Dyskinesia Schizophrenia Female France Independent Living medicine.symptom business Needs Assessment 030217 neurology & neurosurgery Antipsychotic Agents |
Zdroj: | The Journal of Clinical Psychiatry. 80 |
ISSN: | 1555-2101 |
Popis: | Background: Extrapyramidal side effects (EPS) have been identified as a complication of antipsychotic treatment. Previous meta-analyses have investigated EPS prevalence and risk factors in randomized clinical trials with highly selected patients, but studies in real-world schizophrenia are missing. Objective: To examine the prevalence and clinical correlates associated with EPS in a nonselected national multicenter sample of stabilized patients with schizophrenia. Methods: Between 2010 and 2016, patients suffering from schizophrenia (DSM-IV-TR criteria) were recruited through the FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) network and data were collected during a comprehensive 1-day-long standardized evaluation. The Simpson-Angus Scale and the Abnormal Involuntary Movement Scale were used to assess drug-induced parkinsonism (DIP) and tardive dyskinesia, respectively. Results: The overall prevalence of DIP and tardive dyskinesia was 13.2% and 8.3%, respectively, in this community-dwelling sample of 674 patients. DIP was associated with negative symptoms (Positive and Negative Syndrome Scale [PANSS] subscore) (adjusted odds ratio [aOR] = 1.102, P < .001), first-generation antipsychotic prescription (aOR = 2.038, P = .047), and anticholinergic drug administration (aOR = 2.103, P = .017) independently of sex, age, disorganization (PANSS disorganized factor), and antipsychotic polytherapy. Tardive dyskinesia was associated with PANSS disorganized factor (aOR = 1.103, P = .049) independently of sex, age, negative symptoms, excitation, first-generation antipsychotic prescription, and benzodiazepine and anticholinergic drug administration. Conclusions: Our results indicate the high prevalence of EPS in a nonselected community-dwelling clinically stable sample of outpatients with schizophrenia. In the monitoring of antipsychotic treatment, EPS should be systematically evaluated, especially when negative symptoms and disorganization or cognitive alteration are present. Monotherapy with a second-generation antipsychotic should be preferentially initiated for patients with these side effects. |
Databáze: | OpenAIRE |
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