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Incidence of tardive dyskinesia in first-episode psychosis patients treated with low-dose haloperidol.
J Clin Psychiatry. 2003 Sep; 64(9):1075-80.JC

Abstract

BACKGROUND

Previous studies suggest that the risk of tardive dyskinesia is increased with higher doses of conventional antipsychotics. This study evaluates the 12-month incidence of tardive dyskinesia in subjects with first-episode psychosis who were treated with very low doses of haloperidol.

METHOD

Fifty-seven subjects with first-episode psychosis and a DSM-IV diagnosis of schizophreniform disorder, schizophrenia, or schizoaffective disorder were treated according to a fixed protocol with a mean dose of haloperidol of 1.68 mg/day and prospectively studied for 12 months. Subjects were assessed for extrapyramidal symptoms and psychiatric symptoms at 3-month intervals. Data were gathered from 1999 to 2001.

RESULTS

Twelve-month incidence of probable or persistent tardive dyskinesia according to Schooler and Kane criteria was 12.3% (N = 7). Subjects with tardive dyskinesia did not differ from the rest of the sample regarding gender, race, duration of untreated psychosis, or baseline clinical characteristics. Subjects with tardive dyskinesia were older compared with subjects without tardive dyskinesia (37.14 +/- 9.23 vs. 27.30 +/- 8.09 years, respectively; t = -2.77, df = 30, p = .01) and received higher mean doses of haloperidol at 12 months (2.80 +/- 1.64 vs. 1.39 +/- 0.69 mg/day, respectively; t = -3.13, df = 25, p = .004). Cox regression analysis revealed that age at inclusion (p = .031), percentage change in negative symptoms (p = .028), and dose of haloperidol at 12 months (p = .016) were significant predictors of risk for tardive dyskinesia.

CONCLUSION

Incidence of tardive dyskinesia was at least as high as in other samples treated with standard doses of conventional antipsychotics. Subjects at risk for tardive dyskinesia could not be identified on the basis of initial clinical features or acute treatment response. Risk of tardive dyskinesia was related to age, antipsychotic dose, and worsening of negative, depressive, and parkinsonian symptoms.

Authors+Show Affiliations

Department of Psychiatry, University of Stellenbosch Faculty of Health Sciences, P.O. Box 19063, Tygerberg 7505, South Africa. pieto@samedical.co.zaNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14628983

Citation

Oosthuizen, Piet P., et al. "Incidence of Tardive Dyskinesia in First-episode Psychosis Patients Treated With Low-dose Haloperidol." The Journal of Clinical Psychiatry, vol. 64, no. 9, 2003, pp. 1075-80.
Oosthuizen PP, Emsley RA, Maritz JS, et al. Incidence of tardive dyskinesia in first-episode psychosis patients treated with low-dose haloperidol. J Clin Psychiatry. 2003;64(9):1075-80.
Oosthuizen, P. P., Emsley, R. A., Maritz, J. S., Turner, J. A., & Keyter, N. (2003). Incidence of tardive dyskinesia in first-episode psychosis patients treated with low-dose haloperidol. The Journal of Clinical Psychiatry, 64(9), 1075-80.
Oosthuizen PP, et al. Incidence of Tardive Dyskinesia in First-episode Psychosis Patients Treated With Low-dose Haloperidol. J Clin Psychiatry. 2003;64(9):1075-80. PubMed PMID: 14628983.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence of tardive dyskinesia in first-episode psychosis patients treated with low-dose haloperidol. AU - Oosthuizen,Piet P, AU - Emsley,Robin A, AU - Maritz,J Stephanus, AU - Turner,Jadri A, AU - Keyter,N, PY - 2003/11/25/pubmed PY - 2004/2/18/medline PY - 2003/11/25/entrez SP - 1075 EP - 80 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 64 IS - 9 N2 - BACKGROUND: Previous studies suggest that the risk of tardive dyskinesia is increased with higher doses of conventional antipsychotics. This study evaluates the 12-month incidence of tardive dyskinesia in subjects with first-episode psychosis who were treated with very low doses of haloperidol. METHOD: Fifty-seven subjects with first-episode psychosis and a DSM-IV diagnosis of schizophreniform disorder, schizophrenia, or schizoaffective disorder were treated according to a fixed protocol with a mean dose of haloperidol of 1.68 mg/day and prospectively studied for 12 months. Subjects were assessed for extrapyramidal symptoms and psychiatric symptoms at 3-month intervals. Data were gathered from 1999 to 2001. RESULTS: Twelve-month incidence of probable or persistent tardive dyskinesia according to Schooler and Kane criteria was 12.3% (N = 7). Subjects with tardive dyskinesia did not differ from the rest of the sample regarding gender, race, duration of untreated psychosis, or baseline clinical characteristics. Subjects with tardive dyskinesia were older compared with subjects without tardive dyskinesia (37.14 +/- 9.23 vs. 27.30 +/- 8.09 years, respectively; t = -2.77, df = 30, p = .01) and received higher mean doses of haloperidol at 12 months (2.80 +/- 1.64 vs. 1.39 +/- 0.69 mg/day, respectively; t = -3.13, df = 25, p = .004). Cox regression analysis revealed that age at inclusion (p = .031), percentage change in negative symptoms (p = .028), and dose of haloperidol at 12 months (p = .016) were significant predictors of risk for tardive dyskinesia. CONCLUSION: Incidence of tardive dyskinesia was at least as high as in other samples treated with standard doses of conventional antipsychotics. Subjects at risk for tardive dyskinesia could not be identified on the basis of initial clinical features or acute treatment response. Risk of tardive dyskinesia was related to age, antipsychotic dose, and worsening of negative, depressive, and parkinsonian symptoms. SN - 0160-6689 UR - https://www.unboundmedicine.com/medline/citation/14628983/Incidence_of_tardive_dyskinesia_in_first_episode_psychosis_patients_treated_with_low_dose_haloperidol_ L2 - http://www.psychiatrist.com/jcp/article/pages/2003/v64n09/v64n0913.aspx DB - PRIME DP - Unbound Medicine ER -