Objective: To determine the relative risk of tardive dyskinesia in patients with tic disorders by comparing three clinical populations: i) patients with tic disorders without comorbid major psychoses (P^–/T⁺); ii) patients with major psychoses without comorbid tic disorders (P⁺/T^–); and iii) patients with comorbid tic disorders and major psychoses (P⁺/T⁺).

Background: Little is known about the risk of tardive dyskinesia in patients with tic disorders. Available literature suggests that the risk of tardive dyskinesia in this population is lower, however, multiple difficulties exist in interpreting such findings.

Method: Data was collected using the Mayo Data Explorer. All patients who met the following four criteria were included: 1) major psychosis (schizophrenia, schizoaffective disorder, or bipolar disorder) and/or tic disorder was diagnosed at the Mayo Clinic in Rochester, MN; and 2) antipsychotic was prescribed at the Mayo Clinic in Rochester, MN; and 3) patient was a resident of the Olmsted county (where Rochester is located) or the surrounding 6 counties at the time of both diagnosis and antipsychotic prescription; and 4) patient was between 7-79 years old at the time of receiving the first antipsychotic prescription. For comparisons with groups with no cases of tardive dyskinesia, Fisher’s exact test was used. We performed 1:3 matching on age at first antipsychotic exposure, type of antipsychotic, and gender to account for important confounders. For other comparisons, we used logistic regression in an unadjusted and adjusted model (age at first antipsychotic exposure and gender).

Results: None of the 121 patients with P^–/T⁺ (0%); 3/25 patients with P⁺/T⁺ (12%), and 171/4,886 patients with P⁺/T^– (3.5%) patients developed tardive dyskinesia, respectively. Unadjusted analysis showed that risk of tardive dyskinesia was lower in patients with P^–/T⁺ versus patients with P⁺/T^– (0% vs. 3.5%; Fisher’s exact p=0.04). However, after matching there was no evidence of a difference (0% vs. 2.7%; Fisher’s exact p=0.12). Comparison of patients with P⁺/T⁺ versus with P⁺/T^– showed increased risk of tardive dyskinesia in the tic disorder group (OR 3.8, 95% CI 1.1-12.7; p=0.03), association was stronger after adjusting for age at first antipsychotic exposure and gender (OR 5.0, 95% CI 1.4-18.4; p=0.01).

Conclusion: Contrary to the available data, our results do not support that patients with tic disorders have a lower risk of tardive dyskinesia.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/risk-of-tardive-dyskinesia-in-patients-with-tic-disorders-preliminary-results/