Objective: To compare the risk of movement disorders with antipsychotic drugs (APDs) in patients suffering from Schizophrenia or Depressive Disorders.

Background: APDs are well-known causes of movement disorders in schizophrenic patients. APDs are being increasingly used for depressive disorders. It remains unknown to what extent they increase the risk of movement disorders in this population.

Methods: 814 patients with a primary diagnosis of Schizophrenia (n=204) or depressive disorder such as Bipolar Depression (n=343) or Major Depression (n=267) were recruited from psychiatric clinics in Guatemala, Honduras, El Salvador, Panama and Nicaragua. Presence of parkinsonism, dystonia, tardive dyskinesia, tremor, tics, and akathisia were explored by the Simpson-Angus and UKU scales.

Results: Sixty-one patients (7.5%) had movement disorders (parkinsonism=10, dystonia=7, dyskinesias=3, tremor=34, tics=12, akathisia=16). Movement disorders were more frequent in Schizophrenia compared to depressive disorders (11% vs 6% respectively, p<0.05). As shown in Table 1, only male gender and exposure to typical APDs or lithium were independent and significant predictors of the occurrence of movement disorders.

Table 1. Factors related to Movement Disorders (MDs) in schizophrenic and depressive patients

	No MDs (n=753)	MDs (n=61)	Logistic Regression OR (IC 95%)
Age	42.1±15.6	43.3±17
Males	266 (35%)	35 (57%)**	2.21 (1.26-3.88)
Clinical Diagnosis
Schizophrenia	182 (24%)	22 (36%)	1.00 (Ref)
Depression	571 (76%)	39 (64%)*	0.65 (0.35-1.21)
APDs
Typical	38 (5%)	13 (21%)**	4.49 (1.19-16.89)
Atypical antipsychotics	299 (40%)	19 (31%)	0.72 (0.15-3.33)
Lithium	45 (6%)	11 (18%)**	4.55 (1.18-17.54)

* p<0.05, ** p<0.01 vs no MDs” The frequency of movement disorders with APDs in schizophrenic or depressive patients is shown in Table 2.

Table 2. Comparison of the risk of Movement Disorders (MDs) with APDs in schizophrenic and depressive patients.

	Schizophrenia (n=204)		Depression (n=610)
	No MDs (n=182)	MDs (n=22)	No MDs (n=571)	MDs (n=39)
Typical APDs	10 (10%)	6 (27%)**	20 (4%)	7 (18%)**
Atypical APDs	77 (42%)	6 (27%)	222 (39%)	13 (33%)
Lithium	2 (1%)	1 (5%)	43 (7%)	10 (25%)*

APDs= Antipsychotic Drugs. * p<0.05, **p<0.01 vs patients without MDs” Exposure to typical APDs was related to significantly lower risk of movement disorders in schizophrenic patients compared to depressive ones (OR=3.4 [1.2-9.8] vs 6.1 [2.4-15.3], p<0.05). Atypical APDs were not related to an increase in the risk in schizophrenic or depressive patients (OR [95% CI]= 0.78 [0.39-1.55] vs 0.51 [0.19-1.35] respectively, p=0.2). Finally, lithium increased the risk of movement disorders in schizophrenic and depressive patients to a similar extent (OR [95% CI]=4.2 [1.9-9.3] vs 4.1 [0.9-10.5] respectively, p=0.3).

Conclusions: Movement disorders were observed both in schizophrenic or depressive patients. Exposure to typical APDs and lithium increased the risk of movement disorders in both groups of patients. Interestingly, the increase in risk associated with exposure to typical drugs was significantly higher in depressive patients.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/risk-of-movement-disorders-with-antipsychotic-drugs-in-patients-with-schizophrenia-or-depressive-disorders/