The Nithsdale schizophrenia surveys. IX: Akathisia, parkinsonism, tardive dyskinesia and plasma neuroleptic levels

Br J Psychiatry. 1992 Jun:160:793-9. doi: 10.1192/bjp.160.6.793.

Abstract

Of all known schizophrenics living in Nithsdale, south-west Scotland, 146 (88%) were examined for the presence of the three principal movement disorders secondary to antipsychotic medication, namely akathisia, tardive dyskinesia and Parkinsonism. Of these, 18% had akathisia, 5% pseudoakathisia, 29% tardive dyskinesia, 8% persistent tardive dyskinesia, and 27% Parkinsonism. No movement disorder was seen in 445, 36% had one and 20% had more than one movement disorder. Plasma neuroleptic levels at the time of clinical assessment were measured by the radioreceptor technique. Correlations between dose and plasma level were low; the ratio of mean plasma concentration to mean dose was greatest with fluphenazine decanoate and lowest for sulpiride. The concentration:dose ratio was higher in the elderly. There was no relationship between neuroleptic levels and akathisia, Parkinsonism or tardive dyskinesia. Additional psychotropic medication influenced neuroleptic levels. In 9% of patients receiving oral antipsychotic medication, no drug was detected in plasma.

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / blood*
  • Antipsychotic Agents / therapeutic use*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Movement Disorders / blood
  • Movement Disorders / classification
  • Movement Disorders / diagnosis*
  • Plasma / chemistry
  • Plasma / drug effects*
  • Prevalence
  • Psychiatric Status Rating Scales
  • Radioligand Assay
  • Schizophrenia / blood
  • Schizophrenia / drug therapy*
  • Schizophrenia / physiopathology
  • Spectrometry, Fluorescence

Substances

  • Antipsychotic Agents