Neuroleptic use, parkinsonian symptoms, tardive dyskinesia, and associated factors in child and adolescent psychiatric patients

Article Abstract:

Diagnosis and drug treatment of psychiatric disorders in children and adolescents is impeded by a lack of standards and a lack of understanding of the differences between pediatric, adolescent, and adult psychiatry. For instance, neuroleptic, or antipsychotic, medications are narrowly used for psychotic disorders in adults, but in children and adolescents their use is more general. Despite this broader use, side effects associated with neuroleptic medications have not been investigated in children. The present study sought to determine the prevalence and risk factors for movement disorders, induced by neuroleptic medications, in children. Over a six-month period, 104 children and adolescents were evaluated for parkinsonism (tremor, muscular weakness, and rigidity) and tardive dyskinesia (slow, rhythmical, automatic movements such as tongue-rolling). Parkinsonism was seen in 34 percent of subjects who were at risk and was associated with long term neuroleptic treatment. Tardive dyskinesia was seen in 12 percent of patients who were at risk, but was not statistically related to treatment with neuroleptic medication. Symptoms were not typical of those seen in adults. It is suggested that children treated with neuroleptic medication are particularly sensitive to parkinsonism, are possibly vulnerable to develop symptoms of tardive dyskinesia, and that the symptoms children develop may differ from those seen in adults. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Risk factors, Drug use, Psychotherapy patients, Parkinsonism, Pediatric psychopharmacology

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Not all that moves is tardive dyskinesia

Article Abstract:

Long-term treatment with neuroleptic (antipsychotic) medication can result in tardive dyskinesia, a disorder characterized by abnormal, involuntary, muscle movements that often affect the face. Not all such movements are tardive dyskinesia, however. Estimates of the incidence of tardive dyskinesia are probably inflated by such disorders as spontaneous dyskinesia, which have the same clinical presentation. To better estimate the incidence of tardive dyskinesia, it is necessary to look at the incidence of symptoms in patients who have never been treated with neuroleptics. The present investigation examined nine reports on the prevalence of dyskinesia that included data on each patient's history of neuroleptic treatment. Subtracting the cases of obvious non-neuroleptic-related dyskinesia (i.e., spontaneous dyskinesia), the incidence of tardive dyskinesia averaged about 20 percent for all age groups. After the age of 40, the rate of spontaneous dyskinesia increased significantly. It is therefore suggested that tardive dyskinesia is not as prevalent as the statistics indicate, especially in patients over 40 years of age. Many of the symptoms can probably be attributed to spontaneous dyskinesia unrelated to neuroleptic drugs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Demographic aspects, Iatrogenic diseases

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