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Movement disorders in patients with schizophrenia and a history of substance abuse

Movement disorders in patients with schizophrenia and a history of substance abuse
Movement disorders in patients with schizophrenia and a history of substance abuse
OBJECTIVE: The movement disorders acute dystonia, akathisia, Parkinsonian symptoms and tardive dyskinesia [extrapyramidal side effects (EPSs)] are recognized adverse effects of antipsychotic medication. Previous studies have indicated that substance abuse in patients with schizophrenia can worsen EPS. This study therefore investigated the relationship between drug and alcohol use and EPS in a group of patients with schizophrenia.

METHODS: Seventy patients with schizophrenia assessed for drug and alcohol use, global functioning, EPS and suicidality. Chlorpromazine equivalents were correlated to levels of EPS and substance abuse.

RESULTS: Current EPS were found in 65% of the sample despite three-quarters of the patients receiving second-generation antipsychotics. An even higher level of patients, 87%, was found to have a history of EPS. A long history of schizophrenia independently predicted presence of any EPS, particularly akathisia, controlling for history of substance abuse which was a non-significant predictor.

CONCLUSIONS: History or current use of alcohol or drug abuse did not predict EPS, except for alcohol abuse at the time of diagnosis which was associated with current akathisia. Length of illness was correlated with EPS, whereas suicidality was not linked to akathisia. Neither chlorpromazine equivalent antipsychotic dose nor whether the patient received first-generation or second-generation antipsychotic medication was significantly associated with EPS or substance abuse. Copyright © 2013 John Wiley & Sons, Ltd.

alcohol, schizophrenia, substance abuse, akathisia, extrapyramidal side effects, movement disorder
0885-6222
192-197
Hansen, Lars K.
c07afee9-a9d5-4d89-9703-2a603a23b8fe
Nausheen, Bina
947da4a2-c233-45b1-b7b7-eca98a19137d
Hart, Deborah
ea681700-5693-4d5b-80dd-ae94a7a6aaa7
Kingdon, David
14cdc422-10b4-4b2d-88ec-24fde5f4329b
Hansen, Lars K.
c07afee9-a9d5-4d89-9703-2a603a23b8fe
Nausheen, Bina
947da4a2-c233-45b1-b7b7-eca98a19137d
Hart, Deborah
ea681700-5693-4d5b-80dd-ae94a7a6aaa7
Kingdon, David
14cdc422-10b4-4b2d-88ec-24fde5f4329b

Hansen, Lars K., Nausheen, Bina, Hart, Deborah and Kingdon, David (2013) Movement disorders in patients with schizophrenia and a history of substance abuse. Human Psychopharmacology: Clinical and Experimental, 28 (2), 192-197. (doi:10.1002/hup.2305). (PMID:23532750)

Record type: Article

Abstract

OBJECTIVE: The movement disorders acute dystonia, akathisia, Parkinsonian symptoms and tardive dyskinesia [extrapyramidal side effects (EPSs)] are recognized adverse effects of antipsychotic medication. Previous studies have indicated that substance abuse in patients with schizophrenia can worsen EPS. This study therefore investigated the relationship between drug and alcohol use and EPS in a group of patients with schizophrenia.

METHODS: Seventy patients with schizophrenia assessed for drug and alcohol use, global functioning, EPS and suicidality. Chlorpromazine equivalents were correlated to levels of EPS and substance abuse.

RESULTS: Current EPS were found in 65% of the sample despite three-quarters of the patients receiving second-generation antipsychotics. An even higher level of patients, 87%, was found to have a history of EPS. A long history of schizophrenia independently predicted presence of any EPS, particularly akathisia, controlling for history of substance abuse which was a non-significant predictor.

CONCLUSIONS: History or current use of alcohol or drug abuse did not predict EPS, except for alcohol abuse at the time of diagnosis which was associated with current akathisia. Length of illness was correlated with EPS, whereas suicidality was not linked to akathisia. Neither chlorpromazine equivalent antipsychotic dose nor whether the patient received first-generation or second-generation antipsychotic medication was significantly associated with EPS or substance abuse. Copyright © 2013 John Wiley & Sons, Ltd.

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Published date: 27 March 2013
Keywords: alcohol, schizophrenia, substance abuse, akathisia, extrapyramidal side effects, movement disorder
Organisations: Faculty of Medicine

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Local EPrints ID: 351352
URI: http://eprints.soton.ac.uk/id/eprint/351352
ISSN: 0885-6222
PURE UUID: 7f0d39c3-9782-4992-8ac5-5f342130b657

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Date deposited: 18 Apr 2013 14:34
Last modified: 07 Oct 2019 18:34

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Author: Lars K. Hansen
Author: Bina Nausheen
Author: Deborah Hart
Author: David Kingdon

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