EC Neurology

Background: Drug Induced Movement Disorders (DIMDs) are quite common particularly in the setting of antipsychotic use. DIMDs are common with the typical neuroleptics and have become important in the light of limited affordability of atypical antipsychotic drugs and through the later can cause extra pyramidal symptoms but it is rare. These disorders have become relevant in view of the fact that they determine to a large extent drug adherence, legal issues and indeed the prognosis of the primary disorder. In addition, the psychosocial burden these complications of treatment impact on both patients and relatives have made this study imperative. Finally, there is currently no adequate data indicating the exact prevalence and pattern of DIMDs in this environment.

Objective: To determine the prevalence and pattern of drug induced movement disorders in patients on neuroleptics in UPTH.

Methodology: In this prospective study, out of the 2057 patients seen between Jan 2008 – Dec 2010, both as in or out - patients, 103 patients were secondarily diagnosed to have Drug Induced Movement Disorders using the Involuntary Movement Disorder Schedule criteria. This self-administered questionnaire were administered to all patients. The results were analysed.

Results: Out of a total number of 2057 cases seen between 2008 – 2011, 1673 patients were managed with antipsychotic medica- tion. A total of 103 out of this number, representing 6.2%, were diagnosed with either acute or late onset Drug Induced Movement Disorders (DIMD). Out of the total cases, 62 (60.2%) were males while 41 (39.8%) were females. All patients were aged between 18 – 78 years. The common cases that were found with their sex predilection include, acute dystonic reaction in 47 of the 103 patients (45.6%) with a male to female ratio of 2:1, drug induced parkinsonism 28 (27.2%), 2:1; akathisia 15(14.6%), 1:1; tardive dyskinesia 6 (5.8%), 1:2; neuroleptic malignant syndrome 7 (6.8%), 2:1.

Conclusion:The prevalence of DIMDs in UPTH is relatively low (5%) and has been due largely to a shift from the traditional typical neuroleptic to the newer atypical antipsychotics, gradual increase in the dose, careful drug selection (patient-drug match), careful drug initiation and adjustment while the pattern of DIMDs is consistent with several studies worldwide.

Keywords:Prevalence; Pattern; Drug Induced Movement Disorders; UPTH

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