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P.3.049 Prevalence of tardive dyskinesia in inpatients using antipsychotics
P3 Psychotic disorders and antipsychotics
$476
References
References
[1] Cornblatt B, Carson WH, Ali M, et al. Neurocognitive effects of aripiprazole vs. olanzapine in stable psychosis. 23rd CINP meeting, Montreal, 2002 (Poste0. [2] Marder SR, McQuade RD, Stock E, et al. Aripiprazole in the treatment of schizophrenia: safety and tolerability in short term, placebo controlled trials. Schizophrenia Res. 2003; 61:123 136. [3] Tandon R, Stock E, Kuwaja M, et al. Broad effectiveness trial with aripirazole. 55th Institute on Psychiatric Services meeting, Boston Mass, 2003.
[1] Rubio G, Casas M. 2001. Revisirn del tratamiento de la esquizofi'enia en individuos con abuso de drogas. Actas Esp Psiquiatr 29: 124-130.
•
Risperidone versus zuclopenthixol in the treatment of schizophrenia with substance abuse comorbidity: a long-term controlled study
G. Rubio 1 *, I. Marfinez-Gras 1, G. Ponce 2, F. Ldpez-Mufioz 3, C. Alamo 3, M.A. Jimenez-Arriero 2, T. Palomo 2 . ]Mental health
Services, Psychiatty, Madrid, Spain; 2Hospital 12 de Octubre, Psychiatty, Spain; 3Faculty of Medicine, University of Alcala, Pharmacology, Spain Background: Substance use disorders (SUDs) are present in more than 50% of subjects diagnosed with schizophrenia. However, there are no controlled studies assessing the efficacy of antipsychotic drugs in this subgroup of patients [1]. The aim of the present work was to compare the efficacy of risperidone and zuclopenthixol in a sample of schizophrenic subjects with dual diagnosis. Methods: Once each one of the therapeutic groups (risperidone and zuclopenthixol) had been randomized, the patients were treated for the first six months with one antipsychotic and the second six months with the other antipsychotic. Blind evaluators interviewed the patients every two months with the following instruments: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Scale (CGI), Extrapyramidal Symptom Rating Scale (ESRS) and UKU Side Effect Rating Scale. Participants attended their local clinic once a week to take urine drugs tests, adjust their doses of medication and receive training on how to reduce their consumption of substances (Substance Abuse Management Module, SAMM). Sample: Of a total of 124 males with dual diagnosis, 33 were selected for treatment with risperidone, while another 33 were treated with zuclopenthixol. Mean age of the two groups was 34.5 (sd: 8.6) and the commonest type of schizophrenia was paranoid (57.6%). Substances most commonly used were alcohol, cannabis (both 82%) and cocaine (32%). Results: During the first six months there were no significant differences between the scores obtained by each group in the PANSS subscales. The risperidone group patients presented fewer positive urine tests and showed better compliance with the SAMM programme. In the second period the patients treated with risperidone significantly improved their scores on the PANSSnegative subscale, and also presented fewer extrapyramidal symptoms (EPS). Differences between the CGIs obtained at month 6 and at month 12 indicated that the subjects who moved from risperidone to zuclopenthixol worsened, while those who moved from zuclopenthixol to risperidone significantly improved. Conclusions: Risperidone is more effective than zuclopenthixol in improving the symptoms of schizophrenia and substance use. Risperidone was a determining factor in explaining the better compliance with the SAMM.
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Prevalence of tardive dyskinesia in inpatients using antipsychotics
J.H. Choi 1 *, D.Y. Oh 2. ]National Medical Centet; Psychiatty, Seoul, Republic of Korea; 2Kwan Dong University, Psychiatty, Republic of Korea Objective: This study was to investigate the prevalence of tardive dysldnesia (TD) in Korean inpatients using antipsychotics and the relationship between TD and sociodemographic, clinical variables. Method: A cross-sectional assessment of randomly selected inpatients (n 324; mean age 39.73±9.63 years) with DSM-IV schizophrenia, schizoaffective, bipolar disorder was p e r f o r m e d with standard rating instrument for TD and extrapyramidal symptoms. The relations between the prevalence of TD and sex, age, length ofmedication and dosage of antipsychotics, clozapine, and other psychotropic medication, EPS were analyzed with Chisquare test or t-test. Results: Using Schooler and Kane's criteria, 20 subjects (6.17%) had TD. TD was significantly less prevalent in patients receiving clozapine. There was no other significant difference between the TD and without TD groups with respect to type of antipsychotics, other psychotropic drug, antiparldnsonian drug, mood stabilizer augmentation Prevalence of Tardive Dysldnesia with the use of different drugs Prevalence of TD
With (%) Without (%) P value
Atypical antipsychotics 8.02 Clozapine 1.96 Combination of other psychotropic drugs 6.64 Add of antiparkinsonian drug 6.05
3.77 6.13 4.82 6.58
0.354 0.012 0.552 0.866
Conclusion: The results of this study have confirmed the lower prevalence of TD among inpatients using antipsychotics compared to previous investigations. The study has also replicated the association of TD with older age. Clozapine use was associated with lower prevalence rate of TD.
References [1] Schooler NR, Kane JM. Research diagnoses for tardive dyskinesia. Arch Gen Psychiatry. 1982; 39: 486M87.
•
Association analysis of dopamine D2 receptor genetic variants and tardive dyskinesia in schizophrenia following long-term antipsychotic treatment
Y.-J. Liou*. Yuli Veterans Hospital, Department of Psychiatty, Hualien, Taiwan Purpose: Tardive dysldnesia is an adverse movement effect after long-term antipsychotic treatment. The dopamine D2 receptor may be a candidate for studying the pathogenesis of TD because most typical antipsychotics are potent D2 receptor antagonists. However, previous findings regarding the association between
$476
References
References
[1] Cornblatt B, Carson WH, Ali M, et al. Neurocognitive effects of aripiprazole vs. olanzapine in stable psychosis. 23rd CINP meeting, Montreal, 2002 (Poste0. [2] Marder SR, McQuade RD, Stock E, et al. Aripiprazole in the treatment of schizophrenia: safety and tolerability in short term, placebo controlled trials. Schizophrenia Res. 2003; 61:123 136. [3] Tandon R, Stock E, Kuwaja M, et al. Broad effectiveness trial with aripirazole. 55th Institute on Psychiatric Services meeting, Boston Mass, 2003.
[1] Rubio G, Casas M. 2001. Revisirn del tratamiento de la esquizofi'enia en individuos con abuso de drogas. Actas Esp Psiquiatr 29: 124-130.
•
Risperidone versus zuclopenthixol in the treatment of schizophrenia with substance abuse comorbidity: a long-term controlled study
G. Rubio 1 *, I. Marfinez-Gras 1, G. Ponce 2, F. Ldpez-Mufioz 3, C. Alamo 3, M.A. Jimenez-Arriero 2, T. Palomo 2 . ]Mental health
Services, Psychiatty, Madrid, Spain; 2Hospital 12 de Octubre, Psychiatty, Spain; 3Faculty of Medicine, University of Alcala, Pharmacology, Spain Background: Substance use disorders (SUDs) are present in more than 50% of subjects diagnosed with schizophrenia. However, there are no controlled studies assessing the efficacy of antipsychotic drugs in this subgroup of patients [1]. The aim of the present work was to compare the efficacy of risperidone and zuclopenthixol in a sample of schizophrenic subjects with dual diagnosis. Methods: Once each one of the therapeutic groups (risperidone and zuclopenthixol) had been randomized, the patients were treated for the first six months with one antipsychotic and the second six months with the other antipsychotic. Blind evaluators interviewed the patients every two months with the following instruments: Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Scale (CGI), Extrapyramidal Symptom Rating Scale (ESRS) and UKU Side Effect Rating Scale. Participants attended their local clinic once a week to take urine drugs tests, adjust their doses of medication and receive training on how to reduce their consumption of substances (Substance Abuse Management Module, SAMM). Sample: Of a total of 124 males with dual diagnosis, 33 were selected for treatment with risperidone, while another 33 were treated with zuclopenthixol. Mean age of the two groups was 34.5 (sd: 8.6) and the commonest type of schizophrenia was paranoid (57.6%). Substances most commonly used were alcohol, cannabis (both 82%) and cocaine (32%). Results: During the first six months there were no significant differences between the scores obtained by each group in the PANSS subscales. The risperidone group patients presented fewer positive urine tests and showed better compliance with the SAMM programme. In the second period the patients treated with risperidone significantly improved their scores on the PANSSnegative subscale, and also presented fewer extrapyramidal symptoms (EPS). Differences between the CGIs obtained at month 6 and at month 12 indicated that the subjects who moved from risperidone to zuclopenthixol worsened, while those who moved from zuclopenthixol to risperidone significantly improved. Conclusions: Risperidone is more effective than zuclopenthixol in improving the symptoms of schizophrenia and substance use. Risperidone was a determining factor in explaining the better compliance with the SAMM.
•
Prevalence of tardive dyskinesia in inpatients using antipsychotics
J.H. Choi 1 *, D.Y. Oh 2. ]National Medical Centet; Psychiatty, Seoul, Republic of Korea; 2Kwan Dong University, Psychiatty, Republic of Korea Objective: This study was to investigate the prevalence of tardive dysldnesia (TD) in Korean inpatients using antipsychotics and the relationship between TD and sociodemographic, clinical variables. Method: A cross-sectional assessment of randomly selected inpatients (n 324; mean age 39.73±9.63 years) with DSM-IV schizophrenia, schizoaffective, bipolar disorder was p e r f o r m e d with standard rating instrument for TD and extrapyramidal symptoms. The relations between the prevalence of TD and sex, age, length ofmedication and dosage of antipsychotics, clozapine, and other psychotropic medication, EPS were analyzed with Chisquare test or t-test. Results: Using Schooler and Kane's criteria, 20 subjects (6.17%) had TD. TD was significantly less prevalent in patients receiving clozapine. There was no other significant difference between the TD and without TD groups with respect to type of antipsychotics, other psychotropic drug, antiparldnsonian drug, mood stabilizer augmentation Prevalence of Tardive Dysldnesia with the use of different drugs Prevalence of TD
With (%) Without (%) P value
Atypical antipsychotics 8.02 Clozapine 1.96 Combination of other psychotropic drugs 6.64 Add of antiparkinsonian drug 6.05
3.77 6.13 4.82 6.58
0.354 0.012 0.552 0.866
Conclusion: The results of this study have confirmed the lower prevalence of TD among inpatients using antipsychotics compared to previous investigations. The study has also replicated the association of TD with older age. Clozapine use was associated with lower prevalence rate of TD.
References [1] Schooler NR, Kane JM. Research diagnoses for tardive dyskinesia. Arch Gen Psychiatry. 1982; 39: 486M87.
•
Association analysis of dopamine D2 receptor genetic variants and tardive dyskinesia in schizophrenia following long-term antipsychotic treatment
Y.-J. Liou*. Yuli Veterans Hospital, Department of Psychiatty, Hualien, Taiwan Purpose: Tardive dysldnesia is an adverse movement effect after long-term antipsychotic treatment. The dopamine D2 receptor may be a candidate for studying the pathogenesis of TD because most typical antipsychotics are potent D2 receptor antagonists. However, previous findings regarding the association between