Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
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Tardive Dyskinesia and Tardive Dystonia with Second-Generation Antipsychotics in Bipolar Disorder Patients Unexposed to First-Generation Antipsychotics

양극성 장애 환자에서 비정형 항정신병약물 치료 후에 나타나는 지연성 운동장애와 지연성 근긴장이상의 유병률 및 위험요인

  • Lee, Ahram (Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Kim, Joo Hyun (Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Baek, Ji Hyun (Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Kim, Ji Sun (Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Choi, Mi Ji (Center for Clinical Research, Samsung Biomedical Research Institute) ;
  • Yoon, Se Chang (Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Ha, Kyooseob (Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Hong, Kyung Sue (Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center)
  • 이아람 (성균관대학교 의과대학 삼성서울병원 정신건강의학교실) ;
  • 김주현 (성균관대학교 의과대학 삼성서울병원 정신건강의학교실) ;
  • 백지현 (성균관대학교 의과대학 삼성서울병원 정신건강의학교실) ;
  • 김지선 (서울대학교 의과대학 분당서울대학교병원 정신건강의학교실) ;
  • 최미지 (삼성생명과학연구소) ;
  • 윤세창 (성균관대학교 의과대학 삼성서울병원 정신건강의학교실) ;
  • 하규섭 (서울대학교 의과대학 분당서울대학교병원 정신건강의학교실) ;
  • 홍경수 (성균관대학교 의과대학 삼성서울병원 정신건강의학교실)
  • Received : 2015.07.14
  • Accepted : 2015.08.21
  • Published : 2015.11.30
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Abstract

Objectives Second-generation antipsychotics (SGAs) are frequently used in the treatment of bipolar disorder. However, there is still no consensus on their risk of tardive movement syndromes especially for first-generation antipsychotics (FGAs)-naïve patients. This study aimed to investigate the prevalence and associated factors of SGAs-related tardive dyskinesia and tardive dystonia in patients with bipolar disorder, in a naturalistic out-patient clinical setting. Methods The authors assessed 78 non-elderly patients with bipolar (n = 71) or schizoaffective disorder (n = 7) who received SGAs with a combined use of mood stabilizers for more than three months without previous exposure to FGAs. Multiple direct assessments were performed and hospital records longer than one recent year describing any observed tardive movement symptoms were also reviewed. Results The prevalence rates of tardive dyskinesia and tardive dystonia were 7.7% and 6.4%, respectively. These patients were being treated with ziprasidone, risperidone, olanzapine, quetiapine, or paliperidone at the time of the onset of the movement symptoms. Tardive dyskinesia was mostly observed in the orolingual area, and tardive dystonia was most frequently detected in oromandibular area. A past history of acute dystonia was significantly associated with presence of both tardive movement syndromes. Conclusions Our findings suggest that SGAs-related tardive movement syndromes occur in a substantial portion of bipolar disorder patients. Acute dystonia, a reported risk factor of tardive movement syndromes in the era of FGAs is confirmed as a risk factor of both tardive dyskinesia and tardive dystonia that were induced-by SGAs.

Keywords

References

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