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Factors associated with expression of extrapyramidal symptoms in users of atypical antipsychotics

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Abstract

Purpose

The aim of this study was to investigate factors associated with the occurrence of extrapyramidal symptoms (EPS) in users of second-generation antipsychotics (SGA).

Methods

Observational cross-sectional study based on a random sample of subjects from three outpatient clinics. Inclusion criteria were age between 18 and 65 years, of both genders, with a diagnosis of schizophrenia and under the use of a single SGA agent. Subjects who had received i.m. long-acting antipsychotics in the past were excluded. The families of eligible patients were contacted by phone and, if willing to participate in the study, a household visit was scheduled. Informed consent was obtained from all study subjects and their next of kin. The risk of EPS associated with sociodemographic, clinical features and medications used was analyzed by logistic regression.

Results

The study population consisted of 213 subjects. EPS were observed in 38.0% of subjects. The more commonly used SGA were olanzapine (76, 35.7%), risperidone (74, 34.3%), quetiapine (26, 12.2%), and ziprasidone (23, 10.8%). Among the drugs used as adjunctive therapy for schizophrenia, benzodiazepines were the most prevalent (31.5%), followed by carbamazepine (24.4%) and antidepressants (20.2%). Multivariate analysis showed that the risk of EPS was associated with the use of carbamazepine (odds ratio 3.677, 95% CI 1.627–8.310). We found no evidence that the type of SGA modified the risk of EPS.

Conclusion

The occurrence of EPS in SGA users is a common finding, with no difference of antipsychotics studied in relation to the risk of extrapyramidal manifestations. The adjunctive use of carbamazepine may predispose the user of SGA to the occurrence of EPS.

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Authors and Affiliations

  1. Postgraduate Program in Pharmaceutical Science, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil

    Susana Barbosa Ribeiro

  2. Department of Biophysics and Pharmacology, Universidade Federal do Rio Grande Norte, Natal, RN, Brazil

    Aurigena Antunes de Araújo

  3. Postgraduate Programs in Biological Science/Postgraduate Programs RENORBIO, Universidade Federal do Rio Grande Norte, Natal, RN, Brazil

    Caroline Addison Xavier Medeiros

  4. Postgraduate Program in Public Health, Universidade Federal do Rio Grande Norte, Natal, RN, Brazil

    Katarina Melo Chaves & Maria do Socorro Costa Feitosa Alves

  5. Pharmacy Department, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil

    Antonio Gouveia Oliveira & Rand Randall Martins

Authors
  1. Susana Barbosa Ribeiro
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  2. Aurigena Antunes de Araújo
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  3. Caroline Addison Xavier Medeiros
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  4. Katarina Melo Chaves
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  5. Maria do Socorro Costa Feitosa Alves
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  6. Antonio Gouveia Oliveira
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  7. Rand Randall Martins
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Corresponding author

Correspondence to Rand Randall Martins.

Ethics declarations

The study was approved by the Ethics Committee for Research of the University Hospital Onofre Lopes under the number 207/09. The study complied with the Declaration of Helsinki of the World Medical Association. On the first visit after phone contact, all participants and the next of kin or caregiver signed an informed consent before any data was collected.

Conflict of interest

The authors declare that they have no conflict of interest.

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Ribeiro, S.B., de Araújo, A.A., Medeiros, C.A.X. et al. Factors associated with expression of extrapyramidal symptoms in users of atypical antipsychotics. Eur J Clin Pharmacol 73, 351–355 (2017). https://doi.org/10.1007/s00228-016-2166-2

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  • DOI: https://doi.org/10.1007/s00228-016-2166-2

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