Tardive dyskinesia remains a major public health problem in psychiatry. Despite increasing attention and research no safe and effective treatment has been established, therefore, identification of risk factors and prevention remain important goals. Knowledge with regard to risk factors is almost entirely based on cross-sectional prevalence surveys and retrospective data collection on important diagnostic, illness history and treatment history characteristics. The continuation of the present investigation would provide a unique opportunity to build upon a prospectively collected data base on the incidence and course of TD as well as risk factors. To date 878 patients have entered the study including 70 patients with no exposure to neuroleptics, 218 patients with less than 3 months total exposure at the time of study entry and 107 patients receiving different controlled dosage ranges of fluphenazine decanoate. The median length of total previous neuroleptic exposure at study entry (for those who have been treated) is 12 months, therefore patients are being followed from the early part of their treatment course. Sixty-four patients with a documented history of severe Parkinsonian side effects to neuroleptic treatment are also being followed. Patients are evaluated every three months with the Simpson Dyskinesia Scale, the Simpson-Angus Scale and the BPRS. Patients with questionable signs are seen monthly. Those developing presumptive TD are evaluated neuromedically, videotaped and seen every two weeks with discontinuation of neuroleptic medication whenever possible. To date 112 cases of presumptive TD have developed and a major focus of the project at present is to study TD outcome and to evaluate the effect of prospectively assessed variables on both the development of TD and its subsequent course. An additional three years will allow us to determine incidence beyond 5-6 years of cumulative neuroleptic exposure, to further characterize the long-term course of TD and to initiate major analyses of the very large data base we have accumulated.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH032369-10
Application #
3375332
Study Section
(PCBB)
Project Start
1979-03-01
Project End
1989-03-31
Budget Start
1988-04-01
Budget End
1989-03-31
Support Year
10
Fiscal Year
1988
Total Cost
Indirect Cost
Name
Long Island Jewish Medical Center
Department
Type
DUNS #
City
New Hyde Park
State
NY
Country
United States
Zip Code
11040
Woerner, Margaret G; Correll, Christoph U; Alvir, Jose Ma J et al. (2011) Incidence of tardive dyskinesia with risperidone or olanzapine in the elderly: results from a 2-year, prospective study in antipsychotic-naïve patients. Neuropsychopharmacology 36:1738-46
Correll, Christoph U; Leucht, Stefan; Kane, John M (2004) Lower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies. Am J Psychiatry 161:414-25
Kane, J M (1999) Management strategies for the treatment of schizophrenia. J Clin Psychiatry 60 Suppl 12:13-7
Kane, J M (1999) Tardive dyskinesia in affective disorders. J Clin Psychiatry 60 Suppl 5:43-7;discussion 48-9
Kane, J M (1999) Pharmacologic treatment of schizophrenia. Biol Psychiatry 46:1396-408
Miller, C H; Mohr, F; Umbricht, D et al. (1998) The prevalence of acute extrapyramidal signs and symptoms in patients treated with clozapine, risperidone, and conventional antipsychotics. J Clin Psychiatry 59:69-75
Woerner, M G; Alvir, J M; Saltz, B L et al. (1998) Prospective study of tardive dyskinesia in the elderly: rates and risk factors. Am J Psychiatry 155:1521-8
Chakos, M H; Alvir, J M; Woerner, M G et al. (1996) Incidence and correlates of tardive dyskinesia in first episode of schizophrenia. Arch Gen Psychiatry 53:313-9
Umbricht, D; Kane, J M (1996) Medical complications of new antipsychotic drugs. Schizophr Bull 22:475-83
Woerner, M G; Alvir, J M; Kane, J M et al. (1995) Neuroleptic treatment of elderly patients. Psychopharmacol Bull 31:333-7

Showing the most recent 10 out of 26 publications