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Movement Disorders After Exposure to Antipsychotic Drugs in Patients With Depressive Disorders

Rey, María Verónica, PharmD*; Molina, Luis, MD; Recinos, Byron, MD; Paz, Bezner, MD§; Rovelo, Mauricio, MD; Rodriguez Elias, Fanny Elizabeth, MD; Calderón, José, MD#; Arellano, Arturo, MD**; Perez-Lloret, Santiago, MD, PhD†† for the CA-APD Study Team

doi: 10.1097/WNF.0000000000000300
Original Articles

Objectives The aims of the study were to explore the frequency of movement disorders (MDs) in depressive patients exposed to antipsychotic drugs (APDs) and to compare it with nonexposed depressive patients and APDs-treated schizophrenic patients.

Methods Four hundred fifty-two depressive patients not exposed to APDs (group A), 156 depressives exposed to APDs (group B), and 75 patients with schizophrenia on APDs (group C) were recruited. Presence of MDs was explored by the Simpson-Angus and UKU scales (Registration: NCT02409823).

Results Movement disorders were observed in 5%, 9%, and 13% of patients in groups A to C, respectively (P < 0.001, χ2 for linear trend). A logistic multivariate analysis revealed that male sex (odds ratio = 2.26, 95% confidence interval = 1.13–4.49, P < 0.01), exposure to first-generation (vs second-generation) APDs (odds ratio = 5.71, 95% confidence interval = 2.08–15.66, P < 0.01), and exposure to lithium (odds ratio = 3.99, 95% confidence interval = 1.74–9.14, P < 0.01) were independently and significantly associated with MDs.

Conclusions Male sex, use first-generation APDs, and exposure to lithium were associated with MDs in depression. Therefore, caution is advised with the use of these drugs in depressive patients. Prospective studies are needed to confirm these results.

*Pharmacoepidemiology Unit, Etymos Consulting Group, Buenos Aires, Argentina;

Clínica de Especialidades Altamira, Managua, Nicaragua;

Universidad San Carlos de Guatemala, Guatemala;

§Hospital Juan de Dios de San Pedro, San Pedro;

Instituto de Salud Mental, Tegucigalpa, Honduras;

Colonia Médica, San Salvador, El Salvador;

#Clínica de la Conducta, Panamá, Panamá;

**Drugtech, Corporación Farmacéutica Recalcine, San José de Costa Rica, Costa Rica; and

††Institute of Cardiology Research, University of Buenos Aires, National Research Council (CONICET-ININCA), Buenos Aires, Argentina.

Address correspondence and reprint requests to Santiago Perez-Lloret, MD, PhD, Institute of Cardiology Research (ININCA-CONICET), Marcelo T. de Alvear 2270 (C1122AAJ), Buenos Aires, Argentina; E-mail:

This study was supported by a nonrestrictive educational grant from Drugtech, Recalcine Pharmaceutical Corporation (San José de Costa Rica, Costa Rica). The supporter supplied materials and participated in formulating the outline of the study but had no role in patient selection or interpretation of the evidence. The decision to submit the manuscript was made exclusively by the authors.

Conflicts of Interest and Source of Funding: B.R. has lectured for Pfizer, Asofarma, Lundbeck, and Roche. M.R. has lectured for Bial, Astrazeneca, Asofarma, and Pfizer. F.E.R.E. has lectured for Asofarma and Abbott. A.A. was employed by Drugtech. M.V.R. is CEO of Etymos Consulting Group. L.M., B.P., J.C., and S.P.L. has nothing to disclose.

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