Abstract
BackgroundTo identify the incidence rate of spontaneous dyskinesia (SD) and tardive dyskinesia (TD) in a general population and to examine the association between dykinesia and potential risk factors (exposure to metoclopramide [MCP], antipsychotic drugs, and history of diabetes and psychoses).MethodsA retrospective cohort study was conducted for the years 2001 through 2010, based on medical claims data from the Deseret Mutual Benefit Administrators (DMBA).ResultsThirty-four cases of TD and 229 cases of SD were identified. The incidence rate of TD among persons previously prescribed an antipsychotic or metoclopramide (MCP) (per 1,000) was 4.6 (1.6-7.7) for those with antipsychotic drug use only, 8.5 (4.8-12.2) for those with MCP use only, and 15.0 (2.0-28.1) for those with both antipsychotic and MCP use. In the general population, the incidence rate (per 100,000 person-years) of TD was 4.3 and of probable SD was 28.7. The incidence rates of TD and SD increased with age and were greater for females. Those with diabetes or psychoses had almost a 3-fold greater risk of TD than those without either of these diseases. Persons with schizophrenia had 31.2 times increased risk of TD than those without the disease. Positive associations also existed between the selected diseases and the incidence rate of probable SD, with persons with schizophrenia having 4.4 times greater risk of SD than those without the disease.ConclusionsSD and TD are rare in this general population. Diabetes, psychoses, and especially schizophrenia are positively associated with SD and TD. A higher proportion of those with SD present with spasm of the eyelid muscles (blepharospasm) compared more with the TD cases who present more with orofacial muscular problems.
Highlights
To identify the incidence rate of spontaneous dyskinesia (SD) and tardive dyskinesia (TD) in a general population and to examine the association between dykinesia and potential risk factors
The purpose of the current study was to determine the incidence of all types of dyskinesia in general population and to examine its connection to underlying medical conditions such as diabetes independent of antipsychotic medication use, and in association with use of first-generation antipsychotic drugs and metoclopramide
We present results with a stricter definition of TD and SD, wherein at least two claims were paid for the dyskinesia within a 12 month time period
Summary
To identify the incidence rate of spontaneous dyskinesia (SD) and tardive dyskinesia (TD) in a general population and to examine the association between dykinesia and potential risk factors (exposure to metoclopramide [MCP], antipsychotic drugs, and history of diabetes and psychoses). The introduction of chlorpromazine and other antipsychotic drugs into medical practice in the 1950’s revolutionized the treatment of schizophrenia. These drugs were not without some unanticipated side effects. A less common side effect was dyskinesia. Dyskinesia manifests its presence as abnormal involuntary, repetitive, persistent, stereotypic movements usually of the facial muscles but can involve other muscle groups including the extremities and the torso [1]. When this condition occurs sometime after the initiation of antipsychotic
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