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Updated: Jul 12, 2026

Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
Evaluating the cost-effectiveness of reduced tardive dyskinesia with second-generation antipsychotics
1Yale Department of Psychiatry, New Haven, CT, USA. Robert.Rosenheck@Yale.Edu
Background:
Second-generation antipsychotics may have few advantages over older, cheaper drugs, except for possibly reduced risk of tardive dyskinesia.
Aims:
To evaluate the cost-effectiveness of second-generation antipsychotics with regard to reducing tardive dyskinesia.
Method:
Literature was reviewed on risk of tardive dyskinesia with second-generation antipsychotics; on severity, duration and impairment of tardive dyskinesia; and on the relationship of this disorder to quality of life and quality-adjusted life-years (QALYs). Diverse cost and benefit assumptions and of 1-year and 5-year planning horizons were examined in a deterministic sensitivity analysis.
Results:
Estimating 0.143 QALYs lost per case of severe tardive dyskinesia, 1-year cost-effectiveness cumulative estimates ranged from pounds 74,000 (dollars 149,000) to pounds 342,000 (dollars 683,000) per QALY, all above the conventional policy threshold of pounds 25,000 (dollars 50,000).
Conclusions:
Reduction of tardive dyskinesia with second-generation antipsychotics appears unlikely to meet standards for cost-effectiveness.
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