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Extrapyramidal Side Effects in Patients With Alzheimer's Disease Treated With Low-Dose Neuroleptic Medication

Received September 16, 1996; revised January 20, 1997; accepted January 28, 1997. From the Department of Psychiatry, University of California, San Diego, and the Department of Veteran Affairs Medical Center, San Diego, California. Address correspondence to D Caligiuri, Geriatric Psychiatry Clinical Research Center (116A1), VA Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161. e-mail: mcaligiuri{at}ucsd.edu

The authors examined whether the presence of extrapyramidal side effects (EPS), measured before neuroleptic treatment was initiated, could be used to predict the development and severity of neuroleptic-induced parkinsonism (NIP) in Alzheimer's disease (AD). Twenty-four newly medicated probable AD patients were assessed with a battery of measures of extrapyramidal motor function. Assessments were made before neuroleptic therapy, and 3 and 9 months after treatment. Posttreatment clinical findings revealed that 66.7% of the AD patients developed NIP. Patients who developed NIP exhibited more severe pretreatment bradykinesia on instrument-derived measures. These findings suggest that a substantial proportion of AD patients treated with neuroleptics develop significant EPS and that the risk for EPS can be estimated before intervention by use of instruments measuring motor function.

Key Words: Neuroleptic • Alzheimer's Disease

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