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The Nithsdale Schizophrenia Surveys. IX: Akathisia, Parkinsonism, Tardive Dyskinesia and Plasma Neuroleptic Levels

Published online by Cambridge University Press:  02 January 2018

Robin G. McCreadie*
Affiliation:
Crichton Royal Hospital, Dumfries DG1 4TG, Scotland
Lesley J. Robertson
Affiliation:
Crichton Royal Hospital, Dumfries, Greater Glasgow Health Board
David H. Wiles
Affiliation:
Crichton Royal Hospital, Dumfries
*
Correspondence

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 44%, 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.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 

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