Am J Psychiatry 1992; 149:1206-1211
Copyright © 1992 by American Psychiatric Association
Tardive dyskinesia in elderly psychiatric patients: a 5-year study
R Yassa, C Nastase, D Dupont and M Thibeau
Department of Psychiatry, Douglas Hospital Centre, Verdun, Que., Canada.
OBJECTIVE: The authors investigated the prevalence of tardive dyskinesia
among elderly psychiatric patients who had never received neuroleptic
medication before their first hospitalization. METHOD: The study was
performed in the geriatric psychiatry unit of a university- affiliated
hospital in Canada and involved all first-admission patients admitted from
September 1984 through August 1989 who had never taken neuroleptic drugs.
In September and October 1989, the patients who were available for
follow-up were examined and given ratings on the Abnormal Involuntary
Movement Scale to establish the presence or absence of tardive dyskinesia.
The patients' records were reviewed for information on age, diagnosis,
duration of hospitalization, neuroleptic treatment received after
admission, anticholinergic drugs received, and drug-free periods. RESULTS:
Of the 162 patients who were available and whose data were analyzed, a
total of 99 had been treated with neuroleptics, and 35 (35.4%) of these
were found to have tardive dyskinesia. Two of the 35 also had tardive
dystonia. Significantly more patients with major depression than patients
with primary degenerative dementia or delusional psychosis had tardive
dyskinesia. CONCLUSIONS: This study confirms the higher vulnerability of
elderly psychiatric patients treated with neuroleptics to the development
of tardive dyskinesia. The authors stress that caution is especially
necessary when neuroleptics are prescribed for older patients with major
affective disorders.
