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Persistent tardive dyskinesia in bipolar patients
Abstract:
The prevalence and outcome of persistent tardive dyskinesia (TD) was studied in 131 bipolar patients. There were 34 cases of persistent TD in the subgroup (n = 96) with a history of neuroleptic treatment (prevalence, 35.4%; 95% confidence interval, 25% to 45%); there were no cases of persistent TD in the subgroup (n = 35) without such treatment history. Except in one patient, signs of TD persisted in spite of lithium carbonate treatment in 23 patients (median duration, 16 months; range, five to 24 months), of whom 15 remained off of a neuroleptic regimen during the study period for a median duration of 14 months (range, four to 24 months). Using multiple regression analysis, two variables were found to predict the presence of persistent TD and account for 36% of the variance: longer cumulative duration of maintenance neuroleptic treatment and shorter duration of previous lithium carbonate treatment. There appears to be a significant risk of persistent TD among neuroleptic-treated bipolar patients. High-risk subgroups within this category need to be identified.
Insights
Bipolar patients treated with neuroleptics have a significant risk of developing persistent tardive dyskinesia (TD). Longer neuroleptic exposure and shorter lithium treatment predict TD development, highlighting the need to identify high-risk groups.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Tardive dyskinesia (TD) is a potential side effect of neuroleptic medications.
- Bipolar disorder treatment often involves neuroleptics and mood stabilizers like lithium.
- Understanding TD prevalence and risk factors in bipolar patients is crucial for treatment safety.
Purpose of the Study:
- To determine the prevalence and outcome of persistent tardive dyskinesia (TD) in bipolar patients.
- To identify predictors for the development of persistent TD in this population.
Main Methods:
- A cohort of 131 bipolar patients was studied.
- Patients were divided into subgroups based on neuroleptic treatment history.
- Multiple regression analysis was used to identify predictive variables for persistent TD.
Main Results:
- Persistent TD was diagnosed in 35.4% of bipolar patients with a history of neuroleptic treatment (34/96).
- No cases of persistent TD were observed in patients without prior neuroleptic exposure (0/35).
- Longer cumulative neuroleptic treatment duration and shorter previous lithium treatment duration predicted persistent TD, accounting for 36% of the variance.
Conclusions:
- Neuroleptic-treated bipolar patients face a significant risk of developing persistent TD.
- Persistent TD often continues despite lithium treatment and discontinuation of neuroleptics.
- Further research is needed to identify specific high-risk subgroups within neuroleptic-treated bipolar patients.