Incidence of Extrapyramidal Symptoms and Tardive Dyskinesia in Schizophrenia Thirty-Six-Month Results From the European Schizophrenia Outpatient Health Outcomes Study

被引:63
|
作者
Novick, Diego [1 ,2 ]
Haro, Josep Maria [3 ]
Bertsch, Jordan [4 ]
Haddad, Peter M. [5 ,6 ]
机构
[1] Eli Lilly & Co, Lilly Res Ctr, Windlesham GU20 6PH, Surrey, England
[2] Univ Autonoma Barcelona, Dept Psiquiatria, Barcelona, Spain
[3] CIBERSAM, St Joan Deu SSM, Barcelona, Spain
[4] Fundacio St Joan Deu, St Joan Deu SSM, Barcelona, Spain
[5] Univ Manchester, Manchester, Lancs, England
[6] Greater Manchester W Mental Hlth NHS Fdn Trust, Manchester, Lancs, England
关键词
schizophrenia; TD; EPS; antipsychotic treatment; OUTPATIENT HEALTH OUTCOMES; ATYPICAL ANTIPSYCHOTICS; RISK-FACTORS; INVOLUNTARY MOVEMENTS; NEGATIVE SYMPTOMS; ACUTE DYSTONIA; OLDER PATIENTS; PREVALENCE; OLANZAPINE; HALOPERIDOL;
D O I
10.1097/JCP.0b013e3181f14098
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
The incidence of treatment-emergent extrapyramidal symptoms (EPSs) and tardive dyskinesia (TD) in schizophrenic patients, and the clinical characteristics associated with an increased risk of developing EPSs and TD were examined. Patients (N = 7728) in the 3-year, prospective, observational Schizophrenia Outpatient Health Outcomes study were examined according to baseline antipsychotic drug exposure. At baseline, 4893 patients (63.3%) had no EPS, and 6921 (89.6%) had no TD. Extrapyramidal symptoms and TD were assessed separately during follow-up: frequency and time to appearance from Kaplan-Meier survival curves and factors associated with time to appearance using Cox proportional hazard regression models. The cumulative incidence of EPS ranged from 7.7% (olanzapine) to 32.8% (depot typical drugs). Compared with olanzapine, patients taking depot typical drugs, oral typical drugs, risperidone, and amisulpride had a significantly higher risk of developing EPS. Differences from clozapine were marginally significant. High baseline clinical severity was associated with a significantly higher risk of developing EPS. The incidence of TD ranged from 2.8% (olanzapine) to 11.1% (depot typical agent). Compared with olanzapine, patients taking depot typical agents, oral typical agents, and risperidone had a significantly higher risk of developing TD. Baseline factors associated with a significantly higher risk of developing TD were age, EPS, a higher negative Clinical Global Impression score, and presence of gynecomastia. In summary, patients treated with typical antipsychotic agents (oral and depot) and risperidone had a higher risk of developing EPS and TD than patients treated with olanzapine. Higher baseline clinical severity was associated with EPS development, whereas age, presence of EPS, a higher negative Clinical Global Impression score, and presence of gynecomastia were associated with TD development.
引用
收藏
页码:531 / 540
页数:10
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