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Tardive dyskinesia and new antipsychotics

Correll, Christoph Ua,b,c; Schenk, Eva Ma

Current Opinion in Psychiatry: March 2008 - Volume 21 - Issue 2 - p 151–156
doi: 10.1097/YCO.0b013e3282f53132
Schizophrenia: Edited by W. Wolfgang Fleischhacker and Lynn E. DeLisi

Purpose of review To provide an update on tardive dyskinesia rates in patients treated with first-generation or second-generation antipsychotics in studies published since the last systematic review in 2004.

Recent findings Across 12 trials (n = 28 051, age 39.7 years, 59.7% male, 70.9% white, followed for 463 925 person-years), the annualized tardive dyskinesia incidence was 3.9% for second-generation antipsychotics and 5.5% for first-generation antipsychotics. Stratified by age, annual tardive dyskinesia incidence rates were 0.35% with second-generation antipsychotics in children, 2.98% with second-generation antipsychotics versus 7.7% with first-generation antipsychotics (P < 0.0001) in adults, and 5.2% with second-generation antipsychotics versus 5.2% with first-generation antipsychotics (P = 0.865) in the elderly (based almost exclusively on one retrospective cohort study). In four adult studies (n = 2088, age 41.2 years, 71.2% male, 62.0% white), tardive dyskinesia prevalence rates were 13.1% for second-generation antipsychotics, 15.6% for antipsychotic-free patients, and 32.4% for first-generation antipsychotics (P < 0.0001).

Summary Current evidence supports a lower tardive dyskinesia risk for second-generation antipsychotics than for first-generation antipsychotics. Tardive dyskinesia incidence was higher with second-generation antipsychotics than previously reported, possibly due to recent studies with relatively short mean durations and use of nonstandard tardive dyskinesia definitions.

aThe Zucker Hillside Hospital, North Shore – Long Island Jewish Health System, Glen Oaks, New York, USA

bAlbert Einstein College of Medicine, Bronx, New York, USA

cFeinstein Institute for Medical Research, Manhasset, New York, USA

Correspondence to Christoph U. Correll, MD, Psychiatry Research, The Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY 11004, USA E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.