Posted by xjs7 on January 12, 2003, at 14:00:49
In reply to Anyone here take Zyprexa now and again?, posted by denise528 on January 12, 2003, at 11:55:16
Hi Denise,
I remember reading that intermittent use of neuroleptics is a risk factor for TD, so I did a search and found this:
Intermittent Neuroleptic Treatment and Risk for Tardive Dyskinesia: Curaçao Extrapyramidal Syndromes Study III
van Harten PN, Hoek HW, Matroos GE, Koeter M, Kahn RS. Am J Psychiatry 1998;155:565–7.
In this study, the authors examined the association between 3 lifetime medication variables and the occurrence and severity of tardive dyskinesia. The 3 variables are the number of interruptions in neuroleptic treatment, the cumulative amounts of neuroleptics, and the cumulative amounts of anticholinergic medications. The study included 133 patients with a history of taking neuroleptics for at least 3 months who were presently using neuroleptics. The results showed that only the number of neuroleptic interruptions was significantly related to tardive dyskinesia. The risk was 3 times higher for patients with more than 2 neuroleptic interruptions than for patients with 2 or fewer interruptions.
Comments
Without an effective treatment for tardive dyskinesia, clinicians are left to recognize the risk factors. Over the years several studies have advocated the benefits of intermittent neuroleptic therapy in schizophrenia. Since intermittent neuroleptic therapy generally reduces the cumulative amount of neuroleptic medications used, it was thought that such a strategy could reduce the risk of tardive dyskinesia. In recent years, however, research results have not substantiated the benefits of such therapy, and it is not yet a recommended approach. Recommended or not, our patients do this themselves when they stop the medications on their own. In this context, the results of this study are important, as they clearly demonstrate that intermittent neuroleptic treatment is a risk factor for tardive dyskinesia, not only for its presence but also for its severity. Using logistic regression models, the authors have shown that the best model for predicting tardive dyskinesia was the number of interruptions in neuroleptic treatment, second only to the well-known risk factor of age. The question, therefore, is how do we get our patients to comply and to take their medications regularly?
I found this at
http://www.cpa-apc.org/Publications/Archives/Bulletin/1998/Aug/neuropsych.htm
I hope this helps. It is important to know the risks of how we use our medications.
xjs7
poster:xjs7
thread:135517
URL: http://www.dr-bob.org/babble/20030106/msgs/135536.html