Low Incidence of Persistent Tardive Dyskinesia in Elderly Patients With Dementia Treated With Risperidone

Jeste, Dilip V.; Okamoto, Akiko; Napolitano, Jason; Kane, John M.; Martínez, Rick A.

doi:10.1176/appi.ajp.157.7.1150

Cited by 148 publications

(74 citation statements)

References 24 publications

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“…An atypical antipsychotic agent is usually selected on the basis of a patient's clinical profile and in consideration of the agent's efficacy data and specific adverse-effect profile. The positive effects of risperidone and olanzapine on TD symptoms have been reported in clinical trials (1,2,13,14,33,63) and in case studies ( Table 4). Chouinard reported an antidyskinetic effect of risperidone in the multicentre Canadian trial (63).…”

Section: Switching From Conventional To Atypical Antipsychoticsmentioning

confidence: 81%

“…Although the elderly have an increased risk for TD associated with conventional antipsychotic treatment, low rates of movement disorders and TD have been reported in several trials of risperidone in elderly patients with psychosis or dementia (1,2,(29)(30)(31)(32)(33)(34). Davidson and colleagues studied 180 elderly, chronically ill patients with psychosis who received risperidone at a mean dosage of 3.7 mg daily for up to 1 year (31).…”

Section: Atypical Antipsychotics and Tdmentioning

confidence: 99%

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Tardive Dyskinesia in the Era of Typical and Atypical Antipsychotics. Part 2: Incidence and Management Strategies in Patients with Schizophrenia

et al. 2005

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Objective: Tardive dyskinesia (TD), the principal adverse effect of long-term conventional antipsychotic treatment, can be debilitating and, in many cases, persistent. We sought to explore the incidence and management of TD in the era of atypical antipsychotics because it remains an important iatrogenic adverse effect. Methods:We conducted a review of TD incidence and management literature from January 1, 1965, to January 31, 2004, using the terms tardive dyskinesia, management, therapy, neuroleptics, antipsychotics, clozapine, olanzapine, risperidone, quetiapine, ziprasidone, and aripiprazole. Additional articles were obtained by searching the bibliographies of relevant references. We considered articles that contributed to the current understanding of both the incidence of TD with atypical antipsychotics and management strategies for TD. Results:The incidence of TD is significantly lower with atypical, compared with typical, antipsychotics, but cases of de novo TD have been identified. Evidence suggests that atypical antipsychotic therapy ameliorates long-standing TD. This paper outlines management strategies for TD in patients with schizophrenia.

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Section: Switching From Conventional To Atypical Antipsychoticsmentioning

confidence: 81%

Section: Atypical Antipsychotics and Tdmentioning

confidence: 99%

Tardive Dyskinesia in the Era of Typical and Atypical Antipsychotics. Part 2: Incidence and Management Strategies in Patients with Schizophrenia

et al. 2005

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“…Although we found no evidence for an effect of dose on TD risk in this study where doses were very low, resulting in comparable EPS rates for these two SGAs, it is possible that differences between the drugs might emerge at higher dose levels when one would also expect to see a greater differentiation in EPS liability. This is suggested by results from one study in the elderly where there was a dose-dependent TD risk (Jeste et al, 2000). It must be emphasized that interpretation of the comparisons between the TD rates for the two antipsychotics is constrained by the sample size and the fact that the drugs were not randomly assigned.…”

Section: Discussionmentioning

confidence: 99%

“…In the elderly, annualized TD incidence rates for SGAs ranged from 2.5% (olanzapine (Kinon et al, 2005) and risperidone (Jeste et al, 2000)) and 2.7% (quetiapine; Glazer et al, 1999) in patients with exclusive or predominant dementia, to 13.6% with risperidone (Davidson et al, 2000) in patients with mostly chronic schizophrenia, receiving high-dose risperidone, which exerted a dose effect on TD. In the 2004 review (Correll et al, 2004), no concurrent FGA TD rates in the elderly had been available.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Tardive Dyskinesia with Risperidone or Olanzapine in the Elderly: Results from a 2-Year, Prospective Study in Antipsychotic-Naïve Patients

Woerner

Correll

Alvir

et al. 2011

Neuropsychopharmacol

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Tardive dyskinesia (TD) rates with second-generation antipsychotics (SGAs) are considered to be low relative to first-generation antipsychotics (FGAs), even in the particularly vulnerable elderly population. However, risk estimates are unavailable for patients naïve to FGAs. Therefore, we aimed to determine the TD incidence in particularly vulnerable, antipsychotic-naïve elderly patients treated with the SGA risperidone or olanzapine. The present work describes a prospective inception cohort study of antipsychotic-naïve elderly patients aged X55 years identified at New York Metropolitan area in-patient and out-patient geriatric psychiatry facilities and nursing homes at the time of risperidone or olanzapine initiation. At baseline, 4 weeks, and at quarterly periods, patients underwent assessments of medical and medication history, abnormal involuntary movements, and extra-pyramidal signs. TD was classified using Schooler-Kane criteria. Included in the analyses were 207 subjects (age: 79.8 years, 70.0% female, 86.5% White), predominantly diagnosed with dementia (58.9%) or a major mood disorder (30.9%), although the principal treatment target was psychosis (78.7%), with (59.4%) or without (19.3%) agitation. With risperidone (n ¼ 159) the cumulative TD rate was 5.3% (95% confidence interval (CI): 0.7, 9.9%) after 1 year (mean dose: 1.0±0.76 mg/day) and 7.2% (CI: 1.4, 12.9%) after 2 years. With olanzapine (n ¼ 48) the cumulative TD rate was 6.7% (CI: 0, 15.6%) after 1 year (mean dose: 4.3±1.9 mg/day) and 11.1% (CI: 0, 23.1%) after 2 years. TD risk was higher in females, African Americans, and patients without past antidepressant treatment or with FGA co-treatment. The TD rates for geriatric patients treated with risperidone and olanzapine were comparable and substantially lower than previously reported for similar patients in direct observation studies using FGAs. This information is relevant for all patients receiving antipsychotics, not just the especially sensitive elderly.

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“…Risperidone, an antipsychotic drug that presents antagonist properties on dopamine D 2 , serotonin 5HT 2 and α 1 adrenoreceptors, has been the focus of several clinical studies [38,39]. The study carried out by Su et al [40], using MK-801 (ketamine-like NMDA antagonist), showed that risperidone had an inhibitory effect on MK-801-induced hyperactivity in mice, at doses in which it caused no alteration in spontaneous activity when administered alone.…”

Section: Discussionmentioning

confidence: 99%

Activities of the Antipsychotic Drugs Haloperidol and Risperidone on Behavioural Effects Induced by Ketamine in Mice

Arruda

2008

Sci. Pharm.

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This study presents the actions of risperidone (Risp) and haloperidol (Hal) on the behavioral effects elicited by ketamine (Ket) on open-field (OF), rota rod (RR) and tail suspension (TS) tests in mice. Male Swiss albino mice (25-30g) were used. Antipsychotics were administered alone (Risp: 0.1 or 0.2 mg/kg, ip; Hal: 0.1 and 0.2 mg/kg, ip) or thirty minutes before Ket (10 mg/Kg, ip). Ket increased (Ket: 63.3 ± 4.2) the locomotor activity compared to control, while neuroleptics decreased it (25.5 ± 4.2). Pretreatment with neuroleptics, in both doses, blocked hyperlocomotion caused by Ket. In RR, Ket decreased (Ket: 15 ± 4.1) the permanence time of the animals compared to control (Control: 59 ± 0.6), but this effect was not observed when neuroleptics were administered alone. Pretreatment with neuroleptics reverted the effect of Ket only in the RR. While Ket (17.3 ± 5.6) decreased the time of immobility in the tail suspension test compared to the control (80.2 ± 10.2), the pretreatment with neuroleptics reverted this mobility. The action of neuroleptics in this model made possible the blockade of the effects caused by acute administration of Ket. Thus, the mechanism of action of ketamine may involve the dopaminergic system.

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Low Incidence of Persistent Tardive Dyskinesia in Elderly Patients With Dementia Treated With Risperidone

Cited by 148 publications

References 24 publications

Tardive Dyskinesia in the Era of Typical and Atypical Antipsychotics. Part 2: Incidence and Management Strategies in Patients with Schizophrenia

Tardive Dyskinesia in the Era of Typical and Atypical Antipsychotics. Part 2: Incidence and Management Strategies in Patients with Schizophrenia

Incidence of Tardive Dyskinesia with Risperidone or Olanzapine in the Elderly: Results from a 2-Year, Prospective Study in Antipsychotic-Naïve Patients

Activities of the Antipsychotic Drugs Haloperidol and Risperidone on Behavioural Effects Induced by Ketamine in Mice

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