Am J Psychiatry 1992; 149:511-513
Copyright © 1992 by American Psychiatric Association
Prospective study of neuroleptic-induced dystonia in mania and schizophrenia
R Khanna, A Das and SS Damodaran
Central Institute of Psychiatry, Kanke, India.
OBJECTIVE: The authors' goal was to conduct a prospective study comparing
the rate of occurrence of neuroleptic-induced dystonia in a group of
consecutively admitted manic and schizophrenic patients receiving typical
inpatient treatment from several clinicians. METHOD: All patients met the
following criteria: 1) male sex, 2) age between 17 and 45 years, 3)
definite diagnosis of mania or schizophrenia according to Research
Diagnostic Criteria, 4) no exposure to neuroleptics during the past month,
5) absence of past or family history of a neurodegenerative disorder with
extrapyramidal symptoms. All treatment decisions were left to the treating
clinicians. Fifty patients with mania and 33 with schizophrenia were
included in the study. Most of these patients received high-potency
neuroleptics, but the specific neuroleptic used varied in the two groups.
RESULTS: Twelve (24%) of the patients with mania and five (15%) of the
patients with schizophrenia developed acute dystonia. Manic patients
received significantly higher peak doses of neuroleptics during the risk
period for dystonia. Stepwise multiple regression analysis revealed that
the peak neuroleptic dose and age were most strongly related to the
occurrence of dystonia. CONCLUSIONS: This prospective study failed to
support the retrospective finding of another study that acute dystonia
occurred more often in manic patients than in patients with nonparanoid
schizophrenia. The authors conclude that there is a need for carefully
controlled prospective studies with larger groups of patients.
