[Investigation of antipsychotic induced parkinsonism in patients with schizophrenia]

ABSTRACT

Antipsychotic drugs have an important role in psychiatric treatment. Their side effects such as drug induced Parkinsonism, which has been a historical challenge for patients and physicians, account a major cause of treatment rejection by the patients. Drug induced Parkinsonism is the second cause of Parkinson syndrome. The aim of this study was to evaluate antipsychotic induced Parkinsonism in patients with schizophrenia. This cross sectional descriptive study was done in the year 1999 in Noor and Shariaty Hospitals of Isfahan. 200 patients with schizophrenia, affected with Parkinsonism complication, were investigated. Variables were sex, age, dosage and group of drug, duration of treatment, Parkinsonism criteria and simultaneous anti cholinergic prescription. Data was gathered in a questionnaire and analyzed by descriptive statistics and frequency distribution tables. 122 men and 78 women were studied. 26.5% of patients had drug induced Parkinsonism, which was mostly seen in women [32% versus 22.9% in men], higher age [10-19 years 0%, 50 years and higher 33%], and when anticholinergic was not used simultaneously [35.7% versus 25% in anticholinergic users group]. Prevalence of Parkinsonism, in high, medium, and low drug potentials was 28.7%, 29.4% and 19.2%, respectively. Differences in all of the above groups were not significant. Prevalence increased in dosage of less than 100mg [chlorpromazine equivalent dosage] versus 101-300mg [p>0.05], and in 3-6 months after onset of treatment [p<0.05]. The most prevalence criterion was rigidity [84.9%]. Parkinsonism was diagnosed in 11.76% of patients using atypical drug [clozapin]. Anti psychotic induced Parkinsonism increased in higher ages, women and when anticholinergic was not used simultaneously. This side effect was found in all groups even with clozapin. It had a greater prevalence in the beginning of treatment but decreased with treatment continuation and anticholinergic prescription. Future studies particularly on the atypical groups are suggested