Taking these medications for psychosis symptoms at a dose greater than 75 mg per day is linked to an increased risk of involuntary, abnormal, and often jerky movements.
- Tardive dyskinesia corresponds to a set of abnormal involuntary movements of variable amplitude, irregular, sometimes rhythmic, extensive or localized.
- Prescribing a high dose of antipsychotics, greater than 75 mg per day, significantly increases the risk of suffering from this disorder.
- The highest risk is observed in patients receiving 300 mg of these drugs, prescribed mainly for schizophrenia, per day.
Tardive dyskinesia corresponds to a difficulty or an anomaly in the exercise of a movement. More precisely, it is a set of abnormal involuntary movements of variable amplitude, irregular, sometimes rhythmic, extensive or localized, according to the Academy of Medicine. Symptoms, which are often irreversible, occur primarily in the orofacial muscles and occasionally in those of the extremities, trunk, and hip joints. “In addition to physical discomfort, this disorder often leads to low productivity, stigma, social alienation, increased mortality, and noncompliance with treatment for the underlying disease,” reported researchers from the University of Kyūshū (Japan).
Tardive dyskinesia: taking more than 75 mg of antipsychotics per day increases the risk
Since Tardive Dyskinesia mainly occurs in people taking long-term dopamine receptor antagonists, such as antipsychotics, scientists wanted to determine the dose that should not be exceeded in order to avoid suffering from it. Thus, as part of a research, they used a Japanese database collected from 2010 to 2020. The population studied included 58,452 people aged 15 or over who had been diagnosed with schizophrenia, depression or bipolar disorder. and having a prescription for antipsychotics. “The median daily dose of chlorpromazine was 75 mg per day.”
According to the results, published in the journal Journal of Clinical Psychopharmacologyamong the participants, 80 presented with tardive dyskinesia. The authors found that doses greater than 75 mg per day at the last prescription and the maximum dose before the date of diagnosis of tardive dyskinesia were associated with a significantly increased risk of involuntary, abnormal, and often jerky movements. In further analyses, there was a significant relationship between “doses greater than 300 mg per day and the risk of tardive dyskinesia compared to doses less than or equal to 75 mg per day and to doses greater than 75 to less than 300 mg per day. Comparing doses ≥ 300 mg/d to > 75 to < 300 mg/d, the odds ratios at the last prescription and at the maximum dose before the first diagnosis of tardive dyskinesia were respectively 3.40 and 3.50."
Increased monitoring of patients taking antipsychotics is needed
Faced with these data, the team emphasizes that it is crucial to take into account the potential risks of tardive dyskinesia and to closely monitor patients taking antipsychotics. As a reminder, these treatments are indicated mainly in cases of schizophrenia, to relieve the symptoms of psychosis such as delusions, hallucinations, disorganization of thought and aggressiveness.
