Abstract
BackgroundTo study the link between the dosage of several antipsychotics and the prescription of antiparkinsonians in an observational study.MethodsIn the context of a national naturalistic prospective observational study, a database containing all the prescriptions from 100 French psychiatrists during the year 2002 was analysed. The inclusion criteria were a diagnosis of schizophrenia or schizoaffective disorder and age over 18. The mean dosage of antipsychotics with and without antiparkinsonians was compared. Since there were multiple prescriptions for a given subject, generalised mixed linear models were also used to study the link between antiparkinsonian prescription and antipsychotic dosage.Resultsantiparkinsonians were prescribed to 32,9% of the patients. Two groups of antipsychotics were observed relating to differences in dosage when an antiparkinsonian was co prescribed or not : a first group, where the mean dosage was higher with antiparkinsonians (risperidone, amisulpride and haloperidol) and a second group (clozapine, olanzapine), in which antiparkinsonian co prescription was not related to the dosage of antipsychotics.ConclusionAs a conclusion, it can be said that it is important to consider the dosage and the type of antipsychotic in the treatment of patients suffering of schizophrenia, because neurological side effects are frequent and can impair quality of life. Moreover the prescription of antiparkinsonians can lead to different side effects such anticholinergic effects.
Highlights
To study the link between the dosage of several antipsychotics and the prescription of antiparkinsonians in an observational study
Recent meta-analyse tend to show that only certain classes of atypical antipsychotics lead to fewer adverse neurological events[5,6,7]
These meta-analyses point out that the dosage of antipsychotics is decisive for the occure of adverse neurological events
Summary
To study the link between the dosage of several antipsychotics and the prescription of antiparkinsonians in an observational study. Recent meta-analyse tend to show that only certain classes of atypical antipsychotics (olanzapine and clozapine) lead to fewer adverse neurological events[5,6,7]. Because randomised trials study antipsychotics for one or several different dosages, these studies have limitations in the analysis of the link between neurological adverse events and antipsychotic dosage [1]. Observational studies make it possible to study antipsychotic dosage as it is prescribed in ordinary practice. Antiparkinsonians are prescribed for neurological side effects in schizophrenia and the frequency of their (page number not for citation purposes)
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