Tardive dyskinesia in the treatment of schizophrenia: the findings of the Research on Asian Psychotropic Prescription Pattern (REAP) survey (2001 – 2009)

Abstract

Objective: The aim of the study was to survey the frequency of tardive dyskinesia (TD) in patients with schizophrenia and its demographic and clinical correlates in selected Asian countries. Method: A total of 6,761 hospitalized schizophrenia patients in nine Asian countries and territories were examined from 2001 to 2009. TD was evaluated as "present" or "absent" according to the clinical judgment of experienced psychiatrists. The patients' socio-demographic and clinical characteristics and the prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. Results: The frequency of TD in the whole sample was 5.0% with wide variations between countries (0-14.9%). Multiple logistic regression analysis showed that the following variables were independently associated with TD: study time, study site, older age, male gender, more severe negative and extrapyramidal symptoms and less anticholinergic drugs. Conclusions: A generally low frequency of TD in Asian schizophrenia patients with inter-ethnic variations was recorded. It is unclear whether the low prevalence of TD compared with Western data is UHDO RU WKH UHVXOW RI LW EHLQJ LQVXI¿FLHQWO\ recognized.

Tardive dyskinesia in Asia— current clinical practice and the role of neurologists in the care pathway

“…A predominance of TD in women was also found in two reports from Asia: a cross-sectional study of schizophrenic patients in the Philippines ( 55 ) and a retrospective study of elderly psychiatric patients at a single center in Singapore ( 39 ). In contrast, several studies found the opposite, reporting a higher prevalence of TD in male patients ( 50 , 63 , 64 , 87 , 89 , 90 , 108 ). In addition, sex differences in the clinical response to APDs and the side effects experienced have been reported in a study of schizophrenic patients in Pakistan ( 109 ).…”

“…Factors that are reported to occur more commonly in patients with TD in Asia include a long duration of psychiatric illness ( 24 , 55 , 56 , 58 , 60 , 63 – 65 , 87 , 89 ) as well as baseline parkinsonism, a greater severity of extrapyramidal symptoms, or a diagnosis of schizoaffective disorder ( 24 , 50 , 90 ). In addition, some studies have reported fewer years of education in their TD patient cohorts compared to those without TD ( 64 , 87 ).…”

Current perspectives on the epidemiology and burden of tardive dyskinesia: a focused review of the clinical situation in Japan

“… 24 Data from the more recent Research on Asian Psychotropic Prescription Pattern (REAP) survey, which analysed the frequency of TD in inpatients with schizophrenia, found a TD prevalence of 6.5% among Japanese patients. 25 However, it should be noted that this study included only inpatients and thus may not be representative of the entire patient population, as patients with a less-severe form of schizophrenia (i.e. not requiring hospitalisation) were not included.…”

Clinical significance of pharmacogenomic studies in tardive dyskinesia associated with patients with psychiatric disorders

“… 9 Several studies found varying prevalence between different ethnicities. 10 , 11 African ethnicity is associated with higher risk of TD and less likelihood of improvement in a number of studies, even after correcting for antipsychotic dose. 12 , 13 Familial TD has been reported, 14 , 15 even with correction for antipsychotic dose and patient age, 16 further implicating genetic contribution to this condition.…”