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Extrapyramidal Symptoms From Antipsychotics Differ With Age

May 18, 2019

SAN FRANCISCO—Patient age is significantly associated with the type of extrapyramidal symptoms that stem from antipsychotic use, according to a study presented during a poster session at the American Psychiatric Association’s annual meeting.

“Antipsychotic medications are widely used to treat a growing number of mental health disorders. However, their utility may be limited by the potential to cause serious movement adverse reactions,” wrote poster presenter Areef S. Kassam, MD, and coauthor Elizabeth Cunningham, DO. “Akathisia, dystonia, parkinsonism, and tardive dyskinesia (collectively known as extrapyramidal symptoms or EPS) are associated with reduced social and occupational functioning, negative patient attitudes toward treatment, and nonadherence to pharmacotherapy.”

To identify characteristics linked with each type of EPS, researchers reviewed 158 antipsychotic-related EPS events within a large community hospital network.

The study revealed a significant association with age and EPS type: patients with akathisia and dystonia tended to be younger, while patients with parkinsonism and tardive dyskinesia tended to be older, according to the poster abstract.

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In addition, the investigation showed patients with tardive dyskinesia had a greater average body mass index (BMI) and were more likely to be female.

Although correlations of age and BMI in patients with antipsychotic-related EPS observed in the study mesh with previously-reported findings, this study may be the first to identify an association between age and risk of antipsychotic-related akathisia, researchers observed.

“Expanding the knowledgebase of individual characteristics associated with different types of EPS can help providers and patients anticipate and attempt to mitigate these reactions,” they wrote, “and may ultimately improve adherence to antipsychotic therapy.”

—Jolynn Tumolo


“When EPS strikes: characteristics of patients experiencing extrapyramidal symptoms related to antipsychotic therapy.” Abstract presented at: the American Psychiatric Association Annual Meeting; May 18, 2019; San Francisco, CA.

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