You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


Advertisement

ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | RSS | Access Rights | Sign In


  Vol. 52 No. 9, September 1995 TABLE OF CONTENTS
  Online Only
 •  Online First Table of
Contents
  Original Articles
 •Online Features
 This Article
 •References
 •Full text PDF
 • Reply to article
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on Web of Science (205)
 •Contact me when this article is cited
 Related Content
 •Similar articles in this journal
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Delicious Add to Digg Add to Facebook Add to Reddit Add to Technorati Add to Twitter What's this?

Risk of Tardive Dyskinesia in Older Patients

A Prospective Longitudinal Study of 266 Outpatients

Dilip V. Jeste, MD; Michael P. Caligiuri, PhD; Jane S. Paulsen, PhD; Robert K. Heaton, PhD; Jonathan P. Lacro, PharmD; M. Jackuelyn Harris, MD; Anne Bailey, MS; Robert L. Fell, MS; Lou Ann McAdams, PhD

Arch Gen Psychiatry. 1995;52(9):756-765.


Abstract



Background
Neuroleptic-induced tardive dyskinesia (TD) is a major iatrogenic disorder that is more prevalent among older patients. The objective of this study was to determine the incidence of and risk factors for TD in neuroleptic-treated patients over age 45 years.

Methods
We studied 266 middle-aged and elderly outpatients with a median duration of 21 days of total lifetime neuroleptic exposure at study entry. Most patients were treated throughout the study with either a high-potency or a low-potency neuroleptic and maintained on relatively low doses. The patients were followed up at 1- to 3-month intervals with "blind" assessment of psychopathologic condition, clinically as well as instrumentally (ie, using electromechanical sensors with computerized data reduction, including spectral analysis) evaluated movement disorder, and global cognitive function.

Results
Cumulative incidence of TD was 26%, 52%, and 60% after 1,2, and 3 years, respectively. The principal risk factors for TD were duration of prior neuroleptic use at baseline, cumulative amount of high-potency neuroleptics, history of alcohol abuse/dependence, borderline or minimal dyskinesia, and tremor on instrumental assessment.

Conclusion
Use of higher amounts of neuroleptics, particularly high-potency ones, should be avoided in older patients, patients with alcohol abuse/dependence, or patients with a subtle movement disorder at baseline; these patients are at a higher risk of developing TD.



Author Affiliations



From the Department of Psychiatry, University of California, San Diego (Drs Jeste, Caligiuri, Paulsen, Heaton, Lacro, Harris, and McAdams, Ms Bailey, and Mr Fell), and San Diego Veterans Affairs Medical Center (Drs Jeste, Caligiuri, Paulsen, Lacro, and Harris).



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Delicious Delicious   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Low Dose vs Standard Dose of Antipsychotics for Relapse Prevention in Schizophrenia: Meta-analysis
Uchida et al.
Schizophr Bull 2011;37:788-799.
ABSTRACT | FULL TEXT  

Evaluating the cost-effectiveness of reduced tardive dyskinesia with second-generation antipsychotics
Rosenheck
Br. J. Psychiatry 2007;191:238-245.
ABSTRACT | FULL TEXT  

The safety of quetiapine: results of a post-marketing surveillance study on 1728 patients in England
Twaites et al.
J Psychopharmacol 2007;21:392-399.
ABSTRACT  

The relationship between patient satisfaction and treatment outcomes in schizophrenia
Chue
J Psychopharmacol 2006;20:38-56.
ABSTRACT  

Atypical Antipsychotics: Impact on Overall Health and Quality of Life
Boyd
J Am Psychiatr Nurses Assoc 2002;8:S9-S17.
ABSTRACT  

A 23-Year-Old Man With Schizophrenia
Goff
JAMA 2002;287:3249-3257.
FULL TEXT  

Use of atypical antipsychotic drugs in old age psychiatry
Bouman and Pinner
Adv. Psychiatr. Treat. 2002;8:49-58.
FULL TEXT  

The Current Status of Tardive Dyskinesia
Sachdev
Aust N Z J Psychiatry 2000;34:355-369.
ABSTRACT | FULL TEXT  

A randomized trial of risperidone, placebo, and haloperidol for behavioral symptoms of dementia
De Deyn et al.
Neurology 1999;53:946-946.
ABSTRACT | FULL TEXT  

Early Intervention in Schizophrenia in the Elderly
Burke and Shome
Aust N Z J Psychiatry 1998;32:809-814.
ABSTRACT  

Incidence and Correlates of Tardive Dyskinesia in First Episode of Schizophrenia
Chakos et al.
Arch Gen Psychiatry 1996;53:313-319.
ABSTRACT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | PHYSICIAN JOBS | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1995 American Medical Association. All Rights Reserved.