Lower incidence of tardive dyskinesia with risperidone compared with haloperidol in older patients

J Am Geriatr Soc. 1999 Jun;47(6):716-9. doi: 10.1111/j.1532-5415.1999.tb01595.x.


Objective: To compare the 9-month cumulative incidence of tardive dyskinesia (TD) with risperidone to that with haloperidol in older patients.

Design: A prospective longitudinal study.

Setting: An outpatient psychiatric clinic.

Participants: Subjects were middle-aged and older (mean age 66 years) patients with schizophrenia, dementia, mood disorders, or other conditions with psychotic symptoms or severe behavioral disturbances. Sixty-one patients on risperidone were matched with 61 patients from a larger sample of haloperidol-treated patients in regard to age, diagnosis, and length of pre-enrollment neuroleptic intake to create clinically comparable groups. The median daily dose of each medication was 1.0 mg.

Measurements: Abnormal Involuntary Movement Scale, modified Simpson-Angus' scale for extrapyramidal symptoms, Brief Psychiatric Rating Scale, and Mini-Mental State Examination were administered at baseline, 1 month, and 3, 6, and 9 months. The diagnosis of TD was based on specific research criteria. The raters were blind to the patient's medication status.

Results: Life table analysis revealed that patients treated with haloperidol were significantly more likely to develop TD than patients treated with risperidone (P < .05, Peto-Prentice).

Conclusions: The atypical antipsychotic risperidone is significantly less likely to result in TD than the conventional neuroleptic haloperidol in a high-risk group of older patients, at least over a 9-month period.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Antipsychotic Agents / adverse effects*
  • Chi-Square Distribution
  • Dyskinesia, Drug-Induced / epidemiology*
  • Dyskinesia, Drug-Induced / etiology*
  • Female
  • Haloperidol / adverse effects*
  • Humans
  • Incidence
  • Male
  • Mental Disorders / complications
  • Mental Disorders / drug therapy
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Risperidone / adverse effects*
  • Time Factors


  • Antipsychotic Agents
  • Haloperidol
  • Risperidone