Risk of Drug-induced Movement Disorders with Newer Antipsychotic Agents

Tremor Other Hyperkinet Mov (N Y). 2022 Jun 8:12:19. doi: 10.5334/tohm.695. eCollection 2022.

Abstract

Background: The last decade has seen development of numerous novel antipsychotic drugs with unique mechanisms including long-acting formulations for clinical use. A comparative assessment of these new drugs with each other and previous antipsychotics have not been performed with regards to risk for drug-induced movement disorders (DIMD).

Methods: Medline was searched from January 2010 to February 2022 for primary research articles and review articles in English using the search terms "extrapyramidal" and "tardive" with individual drug names of novel antipsychotics.

Results: We identified articles describing the risk of DIMD with 6 novel antipsychotics, 4 novel formulations, and 3 experimental antipsychotics. Both short- and long-term data generally showed comparable to lower risk of DIMD with novel antipsychotics and recent long-acting formulations compared to previously marketed antipsychotics.

Discussion: Several novel antipsychotics, particularly lumateperone and pimavanserin, show promise in being able to treat psychosis while reducing the risk of DIMD. Long-acting paliperidone may reduce risk of DIMD while other long-acting injectable formulations of SGA have similar risk of DIMD compared to oral formulations. New drug targets for treating psychosis without dopamine blockade also show promise.

Keywords: antipsychotics; drug-induced movement disorders; drug-induced parkinsonism; neuroleptic; tardive syndromes.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents* / adverse effects
  • Humans
  • Movement Disorders* / drug therapy
  • Movement Disorders* / etiology
  • Psychotic Disorders*
  • Schizophrenia* / drug therapy

Substances

  • Antipsychotic Agents

Grants and funding

Dr. George T. Kannarkat serves as a consultant for Guidepoint Global. Dr. Stanley Caroff served as consultant for Neurocrine Biosciences and Adamas Pharmaceuticals and received research grants from Neurocrine Biosciences and Eagle Pharmaceuticals unrelated to the current manuscript. Dr. James Morley has served as a consultant to GE Healthcare and received funding from the Department of Defense and the Department of Veteran Affairs unrelated to this review.