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Antipsychotic risks for the elderly.

Tardive dyskinesia (TD), a potentially debilitating movement disorder that can accompany the use of antipsychotic drugs (SN: 5/11/91, p.293), annually afflicts nearly one in three elderly people taking such medication, according to a report in the Nov. 6 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. This represents about six times the annual rate of the new TD cases observed among younger people taking antipsychotics, the researchers note.

Psychiatrist Bruce L. Saltz of Long Island Jewish Medical Center in Glen Oaks, N.Y., and his co-workers tracked 160 patients, aged 57 years and older, who started antipsychotic treatment for the first time at six geriatric facilities or nursing homes in the New York City area. Follow-ups lasted an average of nine months. None of the participants suffered from neurological disorders that produce abnormal movements.

All TD cases appeared within 11 months of usually intermittent drug treatment, the investigators report. Individuals with mood disorders -- such as severe depression -- that included psychotic symptoms proved most vulnerable to TD.

Antipsychotic drugs decrease the availability of the neuro-transmitter dopamine in the brain. Saltz's team proposes that brain cells that process dopamine may naturally decrease in number and function as a person grows old, rendering the elderly more susceptible to TD as antipsychotic drugs further diminish dopamine supplies.

"Although almost all our TD cases were mild, some can be severe, even debilitating, and there is no way to predict who will develop the more severe forms," the researchers conclude.
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Title Annotation:tardive dyskinesia and antipsychotic drug use
Publication:Science News
Date:Nov 16, 1991
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