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S062-1

Prevalence, Manifestation, and Associated Factors of Tardive Movement
Syndromes in the Era of Second-Generation Antipsychotics

Kyung Sue Hong

Sungkyunkwan University, Samsung Medical Center, Korea

Background/Objective: The anticipated reduction of the risk of tardive movement syndromes in the
era of second-generation antipsychotics (SGAs) is not yet well documented and clinical
characteristics of SGAs-induced tardive movement syndromes have yet to be fully explored. This
presentation includes two recent studies (one for schizophrenia and the other for bipolar disorder)
aiming at the investigation of the prevalence, clinical nature, and associated factors of SGA-related
tardive dyskinesia and tardive dystonia in a naturalistic outpatient setting.

Method: Subjects were 80 schizophrenia patients and 78 bipolar disorder patients who received
SGAs for more than one year without any previous exposure to first-generation antipsychotics.
Multiple (≥2) direct assessments of movement symptoms were performed.

Result: A current or past history of tardive dyskinesia and/or tardive dystonia associated with SGA
was identified in 35% of patients with schizophrenia and 16.7% of patients with bipolar disorders.
These patients were being treated with risperidone, amisulpride, olanzapine, aripiprazole,
paliperidone, ziprasidone, quetiapine or clozapine at the time of the onset of the movement
symptoms. Tardive dyskinesia was mostly in the orolingual area, and the most frequently observed
tardive dystonia was torticollis. In schizophrenia, a past history of acute dystonia was significantly
associated with tardive dystonia, and comorbid obsessive-compulsive (OC) syndrome was related to
both tardive movement syndromes. In bipolar disorder, a past history of acute dystonia and lithium
combination showed an association with tardive movement syndromes.

Conclusion: These studies indicate that more clinical attention and research efforts are needed
regarding SGA-induced tardive movement syndromes, including a larger-scale prevalence
assessment. Associated factors of tardive movement syndrome identified in the current studies also
warrant further investigation.

Reference: Ryu S, Yoo JH, Kim JH, Choi JS, Baek JH, Ha K, Kwon JS, Hong KS. Tardive
dyskinesia and tardive dystonia with second-generation antipsychotics in non-elderly schizophrenia
patients unexposed to first-generation antipsychotics: A cross-sectional and retros
Woods SW, Morgenstern H, Saksa JR, et al. Incidence of tardive dyskinesia with atypical versus
conventional antipsychotic medications: a prospective cohort study. J Clin Psychiatry.
2010;71:463-474