Antipsychotics May Elevate Risk of Movement Disorders

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Antipsychotics May Elevate Risk of Movement Disorders
Antipsychotics May Elevate Risk of Movement Disorders

The use of typical antipsychotics in patients with schizophrenia or depression is associated with an increased risk of movement disorders, according to data presented at the 20th International Congress of Parkinson's Disease and Movement Disorders in Berlin.

Interestingly, the same effect was not observed for atypical antipsychotic drugs (APDs). The impact of antipsychotic drugs (APDs) on risk in patients with schizophrenia has been well-characterized, however its affect on patients with depression was previously unknown.  

In order to understand to what extent APDs affect risk of movement disorders in this patient population, Santiago Perez-Lloret, MD, of the National Research Council in Buenos Aires, Argentina, and colleagues recruited 814 patients from psychiatric clinics in South America with a primary diagnosis of schizophrenia (n=204), depressive disorder or bipolar depression (n=343), or major depression (n=287).

Based on the Simpson-Angus and UKU scales, 61 patients had movement disorders, including parkinsonism (n=10), dyskinesias (n=3), tremor (n=34), tics (n=12), or akathisia (n=16). Overall, movement disorders were more prevalent in patients with schizophrenia compared to those with depressive disorders (11% vs 6%, P<.05), however the use of typical APDs (OR=3.4 [1.2-9.8] vs 6.1 [2.4-15.3], P<.05) and lithium (OR [95% CI]=4.2 [1.9-9.3] vs 4.1 [.9-10.5] respectively, P=.3) increased the risk of movement disorders in both patient populations, though the risk was lower in schizophrenia patients compared to depressive patients. The use of atypical APDs was not linked to an increased risk of movement disorders in either patient population (OR [95% CI]= .78 [.39-1.55] vs .51 [.19-1.35] respectively, P=.2).

While the results do not establish causality, the authors note that it is important for clinicians to be aware of these risks when they are prescribing antipsychotics in this patient population.

Reference

Rey MV, Molina L, Recinos B, et al. Abstract 901. Risk of movement disorders with antipsychotic drugs in patients with schizophrenia or depressive disorders. Presented at: 20th International Congress of Parkinson's Disease and Movement Disorders. June 19-23, 2016; Berlin. 

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