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Acute Extrapyramidal Syndromes in Neuroleptic-Treated Elders: A Pilot Study

Psychiatry Service, Portland Veterans Affairs Medical Center, and the Department of Psychiatry, Oregon Health Sciences University, Portland, OR

Ronald Heintz, MD

Psychiatry Service, Portland Veterans Affairs Medical Center, and the Department of Psychiatry, Oregon Health Sciences University, Portland, OR

William F. Hoffman, PhD, MD

Psychiatry Service, Portland Veterans Affairs Medical Center, and the Department of Psychiatry, Oregon Health Sciences University, Portland, OR

George A. Keepers, MD

Psychiatry Service, Portland Veterans Affairs Medical Center, and the Department of Psychiatry, Oregon Health Sciences University, Portland, OR

Daniel E. Casey, MD

Psychiatry Service, Portland Veterans Affairs Medical Center, and the Department of Psychiatry, Oregon Health Sciences University, Portland, OR

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. (J Geriatr Psychiatry Neurol 1991;4:222-225).

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