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What is the incidence and what are the risk factors for acute extrapyramidal syndromes in neuroleptic-treated elders?
What is the incidence and what are the risk factors for acute extrapyramidal syndromes in neuroleptic-treated elders?
Elderly patients treated with neuroleptics have a high incidence of acute extrapyramidal syndromes, which is associated with failure to improve behaviorally and new-onset urinary incontinence.
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Alerts clinicians to monitor EPS closely in neuroleptic-treated elders; leaves open prospective validation of risk factors and outcomes.
The incidence, morbidity, and risk factors for acute extrapyramidal syndromes (EPS) such as akathisia and drug-induced parkinsonism (DIP) in neuroleptic-treated elders have not been systematically explored. This study presents data on 17 elderly patients who were prospectively examined for up to 4 weeks for acute EPS, functional and cognitive status, and behavioral disturbances. Seventy-one percent of subjects developed DIP, and 18% developed akathisia. Predictors of DIP included pre-neuroleptic treatment parkinsonian signs and neuroleptic dose, despite use of low doses of neuroleptics. Development of acute EPS was associated with failure to improve behaviorally. New-onset urinary incontinence was the most common functional abnormality.
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Ganzini et al. (1991) studied this question.
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