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Incidence and risk factors for severe tardive dyskinesia in older patients

Published online by Cambridge University Press:  03 January 2018

Michael P. Caligiuri ,
Jonathan P. Lacro ,
Enid Rockwell ,
Lou Ann McAdams  and
Dilip V. Jeste
Michael P. Caligiuri*
Affiliation:
School of Medicine, University of California, San Diego, and Pharmacy Services of the Veterans Affairs Medical Center, San Diego, USA
Jonathan P. Lacro
Affiliation:
School of Medicine, University of California, San Diego, and Pharmacy Services of the Veterans Affairs Medical Center, San Diego, USA
Enid Rockwell
Affiliation:
School of Medicine, University of California, San Diego, and Pharmacy Services of the Veterans Affairs Medical Center, San Diego, USA
Lou Ann McAdams
Affiliation:
School of Medicine, University of California, San Diego, and Pharmacy Services of the Veterans Affairs Medical Center, San Diego, USA
Dilip V. Jeste
Affiliation:
School of Medicine, University of California, San Diego, and Pharmacy Services of the Veterans Affairs Medical Center, San Diego, USA
*
Dr M. P. Caligiuri, Motor Function Laboratory (116A1), VA Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161, USA
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Abstract

Background

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 severeTD.

Method

We report the results of a longitudinal prospective incidence study of severeTD 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.

Results

The cumulative incidence of severeTD 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 severeTD. 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 severeTD Conclusions 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.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 2 , August 1997 , pp. 148 - 153
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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Footnotes

∗

Presented, in part, at the 36th Annual Meeting of New Clinical Drug Evaluation Unit on 30 May 1996 in Boca Raton, Florida, USA.

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