Antipsychotics at doses >75 mg a day linked to risk for tardive dyskinesia

Antipsychotics at doses >75 mg/day are associated with an increased risk for tardive dyskinesia (TD), according to a study published in the Journal of Clinical Psychopharmacology.

Maki Gouda, from the Mitsubishi Tanabe Pharma Corporation in Osaka, Japan, and colleagues examined the association between antipsychotic doses and the risk for TD in clinical practice in a population of patients aged 15 years or older with a diagnosis of schizophrenia, depression, or bipolar disorder. Patients newly diagnosed with TD were categorized as cases and were matched with a control group in a 1:10 ratio.

The analysis population included 58,452 patients; 80 of these patients were identified as TD cases. The researchers found that doses >75 mg/day at the last prescription and the maximum dose before the date of TD diagnosis were associated with a significantly increased risk for TD.

In post-hoc analyses, there was a significant association between doses ≥300 mg/day versus ≤75 and >75 to <300 mg/day and the risk for TD. The odds ratios were 3.40 and 3.50 when comparing ≥300 mg/day with >75 to <300 mg/day at the last prescription and as the maximum dose before first diagnosis of TD, respectively.

“The prescription of high dose was associated with an increased risk of TD, and the highest risk was observed in the group receiving >300 mg/day,” the authors write. “Therefore, it is crucial to consider the potential risks of TD and to carefully monitor patients receiving antipsychotic treatment.”

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