March 1, 2004American Journal of Psychiatry
Lower Risk for Tardive Dyskinesia Associated With Second-Generation Antipsychotics: A Systematic Review of 1-Year Studies
Why the study?
Do second-generation antipsychotics reduce the risk of tardive dyskinesia compared to first-generation antipsychotics in patients requiring long-term antipsychotic treatment?
Population
2,769 patients from 11 studies receiving treatment with second-generation antipsychotics
Comparison
Second-generation antipsychotics for ≥1 year vs Haloperidol or placebo in the 4 trials that had…
Design
Systematic_review
Follow-up
weighted mean 263 days, median 306 days
Authors
Discussion
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Implication
Supports preferring second-generation antipsychotics over haloperidol to lower tardive dyskinesia risk in long-term use; confirms lower incidence via Level 1 synthesis.
Structured PICO
Do second-generation antipsychotics reduce the risk of tardive dyskinesia compared to first-generation antipsychotics in patients requiring long-term antipsychotic treatment?
P
Population
2,769 patients (77 children, 1,419 adults, 794 mixed adult/elderly, 479 exclusively age ≥54 years) from 11 studies receiving treatment with second-generation antipsychotics
I
Intervention
Second-generation antipsychotics (risperidone, olanzapine, quetiapine, amisulpride, or ziprasidone) for ≥1 year
C
Comparator
Haloperidol (N=408) or placebo (N=71) in the 4 trials that had a comparator
O
Outcome
New cases of tardive dyskinesia or dyskinesiasafety
Second-generation antipsychotics are associated with a lower annual incidence of tardive dyskinesia compared to haloperidol during long-term treatment.
Limitations
- Doses of haloperidol used in the comparator studies were relatively high
- Need for more carefully designed studies lasting beyond 1 year
- Need for studies in patients who have never taken first-generation antipsychotics
Cite This Study
Correll et al. (2004) studied this question.