Neuroleptic-induced marching-in-place

¹Douglas Hospital Research Centre, Verdun, Quebec, Canada.

|January 1, 1989

Abstract:

Marching-in-place (MIP) was observed in 12 out of 133 (9%) chronically hospitalized psychiatric patients and in none of 60 hospital staff controls. The prevalence was similar in both sexes. MIP was associated with tardive dyskinesia or parkinsonism or both but did not occur alone. Counting the number of steps per minute provides a reliable method to quantify MIP and may permit a simple objective method for investigating the neuropharmacology of this phenomenon. Preliminary observations suggest that anticholinergic agents may improve MIP in some patients but worsen it in others.

Insights

Marching-in-place (MIP), a movement disorder, affected 9% of psychiatric patients but no controls. It was linked to other movement issues and may be treatable with anticholinergic drugs.

Area of Science:

Neuroscience
Psychiatry
Movement Disorders

Background:

Marching-in-place (MIP) is an unusual motor phenomenon.
Its prevalence and associations in psychiatric populations are not well-defined.

Purpose of the Study:

To determine the prevalence of MIP in chronically hospitalized psychiatric patients.
To explore associations between MIP and other movement disorders.
To assess potential quantification methods and preliminary treatment responses for MIP.

Main Methods:

Observational study comparing psychiatric patients and hospital staff controls.
Prevalence calculation for MIP.
Clinical assessment for associated movement disorders like tardive dyskinesia and parkinsonism.
Exploration of anticholinergic agent effects.

Main Results:

MIP was observed in 9% of 133 psychiatric patients, with no cases in 60 controls.
MIP was consistently associated with tardive dyskinesia or parkinsonism, or both.
Quantification by steps per minute was found to be reliable.
Anticholinergic agents showed mixed effects, improving MIP in some patients while worsening it in others.

Conclusions:

MIP is a distinct phenomenon observed in a subset of psychiatric patients, linked to specific movement disorders.
Quantifying MIP by steps per minute offers an objective measure for research.
Anticholinergic medications have variable efficacy in treating MIP.

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