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Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
Depot injections and tardive dyskinesia
Summary
Tardive dyskinesia incidence increased in patients on depot antipsychotics, with bucco-linguo-masticatory syndrome rising significantly. While treatments offered temporary relief, long-term neuroleptic management requires careful monitoring and dose reduction.
Area of Science:
- Psychiatry
- Clinical Pharmacology
- Neuroscience
Background:
- Long-term neuroleptic use is associated with movement disorders.
- Tardive dyskinesia (TD) is a significant concern in patients on antipsychotic medications.
Purpose of the Study:
- To determine the incidence of tardive dyskinesia in out-patients receiving depot fluphenazine or depot flupenthixol.
- To assess the impact of these long-acting antipsychotics on the development or worsening of TD.
Main Methods:
- Prospective study involving 374 out-patients.
- Monitoring for bucco-linguo-masticatory syndrome over three years.
- Assessment of neuroleptic treatment history and dosage.
Main Results:
- The incidence of bucco-linguo-masticatory syndrome increased from 8% to 22% over three years.
- Fluphenazine and flupenthixol were equally implicated; 75% of cases were mild.
- Six additional cases of generalized chorea were observed, all on flupenthixol.
Conclusions:
- Depot antipsychotics, specifically fluphenazine and flupenthixol, are associated with an increased incidence of tardive dyskinesia.
- While dose reduction or switching to pimozide or fluspirilene showed improvement, long-term efficacy is uncertain.
- Recommendations include careful monitoring, minimal neuroleptic dosage, and intermittent neuroleptic abstinence.
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