Comparison of Extrapyramidal Symptoms Among Outpatients With Schizophrenia on Long-Acting Injectable Antipsychotics

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Research

Background:

• Extrapyramidal symptoms (EPS) are common adverse effects of antipsychotic medications.
• Different antipsychotic classes have varying risks for EPS.
• Long-acting injectable (LAI) antipsychotics are frequently used in schizophrenia management.

Purpose of the Study:

• To assess and compare the severity of EPS in schizophrenia patients treated with LAI antipsychotics.
• To evaluate EPS risk across partial agonist, second-generation, and first-generation antipsychotic groups.

Main Methods:

• Ninety-two schizophrenia patients on LAI antipsychotics were recruited.
• Extrapyramidal Symptom Rating Scale (ESRS) assessed EPS severity.
• Data on coprescriptions, comorbidities, and demographics were collected and analyzed using 1-way ANOVA.

Main Results:

• No significant differences in total or sub-scores of EPS were found among the three antipsychotic groups.
• Risperidone was associated with higher EPS scores compared to paliperidone, aripiprazole, and flupenthixol.
• Higher than maximum doses of paliperidone were common, but did not correlate with increased EPS severity.

Conclusions:

• The study indicates a comparable risk of EPS across the three main antipsychotic classes.
• Risperidone use was linked to a higher incidence of EPS.
• Consideration of a higher "maximum dose" threshold for paliperidone may be warranted.