Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-06-11T08:37:50.726Z Has data issue: false hasContentIssue false
  • English
  • Français

Dysphoric subjective response to neuroleptics in schizophrenia: relationship to extrapyramidal side effects and symptomatology

Published online by Cambridge University Press:  16 April 2020

M. Gervin ,
S. Browne ,
J. Garavan ,
M. Roe ,
C. Larkin  and
E. O'Callaghan
M. Gervin
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
S. Browne
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
J. Garavan
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
M. Roe
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
C. Larkin
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
E. O'Callaghan*
Affiliation:
The Theodore and Vada Stanley Research Unit, Cluain Mhuire Service, Hospitaller Order St John of God, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
*
*Correspondence: Dr. Eadbhard O’Callaghan, Cluain Mhuire Family Centre, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland.
Get access

Summary

Objective:

Subjective reports of dysphoric responses to neuroleptic medication are common in clinical practice. However, cognitive and affective side effects of neuroleptic medications are difficult to differentiate from the symptoms of schizophrenia. We sought to elucidate the relative contribution of extrapyramidal side effects and symptomatology to dysphoric response.

Method:

Fifty clinically stable outpatients with schizophrenia attending a rehabilitation centre were assessed for extrapyramidal side effects and symptomatology before completing the drug attitude inventory (DAI).

Results:

Presence of extrapyramidal side effects, found in 28 patients (Z = −1.99, p = 0.05), and severity of negative symptoms (r = −0.47, p = 0.001) were independently associated with dysphoric response, explaining a significant proportion of the variance (R = 0.53, R2 = 25.2%, F = 9.27, df = 2, p = 0.0004).

Conclusions:

Patients who report a dysphoric response which they associate with neuroleptic medications have more extrapyramidal side effects and more severe negative symptoms. While these responses may be part of the negative symptoms of the illness or due to other factors such as depression, we raise the possibility that they may be clinically indistinguishable from, and be a subjective measure of, the so-called ‘neuroleptic-induced deficit syndrome’.

Keywords

dysphoriaextrapyramidalneurolepticsschizophreniasymptomatology
Type
Original article
Information
European Psychiatry , Volume 14 , Issue 7 , November 1999 , pp. 405 - 409
Copyright
Copyright © European Psychiatric Association 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, NC. The scale for the assessment of negative symptoms (SANS) Iowa City, Iowa: The University of Iowa; 1983.Google Scholar
Andreasen, NC. The scale for the assessment of positive symptoms (SAPS) Iowa City, Iowa: The University of Iowa; 1984.Google Scholar
Awad, AG. Subjective response to neuroleptics in schizophrenia Schizophr Bull 1993 ;19 : 609-18.CrossRefGoogle Scholar
Awad, AGHogan, TP. Subjective response to neuroleptics and the quality of life: implications for treatment outcome Acta Psychiatr Scand 1994 ; 89 : 27–32.CrossRefGoogle Scholar
Barnes, TREKane, JM. Choosing between old and new antipsychotics Curr Opin Psychiatry 1996 ; 9 : 41-4.CrossRefGoogle Scholar
Browne, S, Roe, MLane, A. et al. Quality of life in schizophrenia: relationship to sociodemographic factors, symptomatology and tardive dyskinesia Acta Psychiatr Scand 1996 ; 94 : 118-24.CrossRefGoogle ScholarPubMed
Carpenter, WTHeinrichs, DWWagman, AMI. Deficit and non-deficit forms of schizophrenia: the concept Am J Psychiatry 1988 ; 145 : 578-83.Google Scholar
Casey, DE. Motor and mental aspects of acute extrapyramidal syndromes Acta Psychiatr Scand 1994 ; 89 Suppl 380 : 14–20.CrossRefGoogle Scholar
Davis, JM. Comparative doses and costs of antipsychotic medication Arch Gen Psychiatry 1976 ; 33 : 858-60.CrossRefGoogle ScholarPubMed
Guy, W. ECDEU: Assessment Manual for Psychopharmacology Washington DC: US Department of Health, Education and Welfare; 1976. p. 534-7.Google Scholar
Hogan, TPAwad, AG. Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures Psychol Med 1992 ; 22 : 347-52.CrossRefGoogle ScholarPubMed
Hogan, TPAwad, AGEastwood, MR. A self-report scale predictive of drug compliance in schizophrenics: reliability and descriminant validity Psychol Med 1983 ; 13 : 177-83.CrossRefGoogle Scholar
Hogan, TPAwad, AGEastwood, MR. Early subjective response and prediction of outcome to neuroleptic drug therapy in schizophrenia Can J Psychiatry 1985 ; 30 : 246-8.CrossRefGoogle Scholar
Kane, JM. Schizophrenia N. Eng J Med 1996 ; 334 : 34-9.CrossRefGoogle ScholarPubMed
Lader, M, The NIDS Working Group. Neuroleptic induced deficit syndrome (NIDS) J Clin Psychiatry 1993 ; 54 : 494–500.Google Scholar
Lewander, LH. Neuroleptics and the neuroleptic induced deficit syndrome Acta Psychiatr Scand 1994 ; 89 Suppl 380 : 8–13.CrossRefGoogle Scholar
Lindstrom, LH. Long-term clinical and social outcome studies in schizophrenia in relation to the cognitive and emotional side effects of antipsychotic drugs Acta Psychiatr Scand 1994 ; 89 Suppl 380 : 74-6.CrossRefGoogle Scholar
Schooler, NR. Deficit symptoms in schizophrenia : negative sympyoms versus neuroleptic-induced deficits Acta Psychiatr Scand 1994 ; 89 Suppl 380 : 21-6.CrossRefGoogle Scholar
Schooler, NRKane, JM. Research diagnoses for tardive dyskinesia Arch Gen Psychiatry 1982 ; 39 : 789-94.Google ScholarPubMed
VanPutten, TMay, PRA. Subjective response as a predictor of outcome in pharmacotherapy Arch Gen Psychiatry 1978 ; 35 : 477-80.CrossRefGoogle Scholar
VanPutten, TMay, PRAMarder, SR, et al. Subjective response to antipsychotic drugs Arch Gen Psychiatry 1981 ; 38 : 187-90.CrossRefGoogle Scholar
Wojcik Doller, JGelenberg, AJLaBrie, RA. Prevalence of tardive dyskinesia in an outpatient population Compr Psychiatry 1980 ; 21 : 370-80.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.