BIOMAT Database Logo BIOMAT Database Logo

The prevalence of acute extrapyramidal signs and symptoms in patients treated with clozapine, risperidone, and conventional antipsychotics. 1998

C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
Department of Biological Psychiatry, Innsbruck University Clinics, Austria.

BACKGROUND Acute extrapyramidal side effects (EPS) are a common phenomenon of treatment with conventional antipsychotics. Previous studies found that clozapine has little propensity to cause EPS, while risperidone produces some EPS, but at levels lower than those of conventional antipsychotics. METHODS We compared the prevalence and severity of EPS in patients treated with clozapine, risperidone, or conventional antipsychotics for at least 3 months. Our main hypothesis was that there would be differences between the three treatment groups with regard to akathisia, measured with the Barnes Akathisia Scale, and extrapyramidal motor side effects (rigidity, rigidity factor, tremor, salivation), measured with the Simpson-Angus scale. Secondarily, we were interested in possible differences between the three groups with respect to the anticholinergic comedication and the subjective impression of the patients, measured with the van Putten scale. RESULTS We studied 106 patients (41 patients treated with clozapine, 23 patients with risperidone, and 42 patients treated with conventional antipsychotics). The sample was 57.5% male and had a mean +/- SD age of 36.6 +/- 9.3 years. The mean dose of antipsychotics calculated in chlorpromazine equivalents was 425.6 +/- 197.1 mg/day in the clozapine group, 4.7 +/- 2.1 mg/day in the risperidone group, and 476.5 +/- 476.9 mg/day in the group treated with conventional antipsychotics. The point-prevalence of akathisia was 7.3% in the clozapine group, 13% in the risperidone group, and 23.8% in the group treated with conventional antipsychotics. The point-prevalence of rigidity and cogwheeling respectively was 4.9% and 2.4% in the clozapine group, 17.4% and 17.4% in the risperidone group, and 35.7% and 26.2% in the group treated with conventional antipsychotics. CONCLUSIONS Our results indicate that risperidone is superior to conventional neuroleptics in that it causes fewer EPS. In comparison to clozapine, risperidone produces EPS levels that are intermediate between clozapine and conventional antipsychotic drugs.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011358 Product Surveillance, Postmarketing Surveillance of drugs, devices, appliances, etc., for efficacy or adverse effects, after they have been released for general sale. Drug Surveillance, Postmarketing,Evaluation Studies, Postmarketing,Postmarketing Product Surveillance,Product Surveillance, Post-Marketing,Drug Surveillances, Postmarketing,Evaluation Study, Postmarketing,Post-Marketing Product Surveillance,Post-Marketing Product Surveillances,Postmarketing Drug Surveillance,Postmarketing Drug Surveillances,Postmarketing Evaluation Studies,Postmarketing Evaluation Study,Postmarketing Product Surveillances,Product Surveillance, Post Marketing,Product Surveillances, Post-Marketing,Product Surveillances, Postmarketing,Studies, Postmarketing Evaluation,Study, Postmarketing Evaluation,Surveillance, Post-Marketing Product,Surveillance, Postmarketing Drug,Surveillance, Postmarketing Product,Surveillances, Post-Marketing Product,Surveillances, Postmarketing Drug,Surveillances, Postmarketing Product
D011618 Psychotic Disorders Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994) Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D003024 Clozapine A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. Clozaril,Leponex
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute

Related Publications

C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
Extrapyramidal symptoms in patients treated with risperidone.
June 1997, Journal of clinical psychopharmacology,
C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
Sexual dysfunction in patients with schizophrenia treated with conventional antipsychotics or risperidone.
January 2009, Neuropsychiatric disease and treatment,
C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
Neurologic soft signs in schizophrenic patients treated with conventional and atypical antipsychotics.
August 2005, Journal of clinical psychopharmacology,
C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
Comments on "neurological soft signs in schizophrenic patients treated with conventional and atypical antipsychotics".
October 2007, Journal of clinical psychopharmacology,
C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
Weight gain in adolescents treated with risperidone and conventional antipsychotics over six months.
January 1998, Journal of child and adolescent psychopharmacology,
C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
Leptin concentrations are increased in subjects treated with clozapine or conventional antipsychotics.
November 2001, The Journal of clinical psychiatry,
C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
A comparison of extrapyramidal symptoms in older outpatients treated with quetiapine or risperidone.
September 2004, Current medical research and opinion,
C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
Overt aggression and psychotic symptoms in patients with schizophrenia treated with clozapine, olanzapine, risperidone, or haloperidol.
April 2004, Journal of clinical psychopharmacology,
C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
Concomitant clozapine reduces smoking in patients treated with risperidone.
February 2002, European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology,
C H Miller, and F Mohr, and D Umbricht, and M Woerner, and W W Fleischhacker, and J A Lieberman
Extrapyramidal signs and clinical symptoms in first-episode schizophrenia: response to low-dose risperidone.
August 1997, Journal of clinical psychopharmacology,
Copied contents to your clipboard!