Clinical Characteristics of 183 Reports of Extrapyramidal Symptoms Induced by Antipsychotics

doi:10.19803/j.1672-8629.20250388

Abstract

Abstract: Objective To explore the clinical characteristics of antipsychotic drug-induced extrapyramidal symptoms (EPS) in order to provide a reference for adverse reaction monitoring of antipsychotic drugs and for rational use of drugs. Methods All EPS reports associated with antipsychotics submitted to the National Adverse Drug Reaction Monitoring Network by Beijing Anding Hospital in 2004—2024 were retrospectively collected (n=183). Patients’ demographic data, clinical manifestations, causative drugs, latency period of adverse reactions, interventions and outcomes were analyzed. The risk of EPS induced by different drugs was compared using the ratio of the number of EPS cases (n) to the defined daily doses (DDDs) for each drug (n/DDDs). Results Among the 183 cases, Patients were predominantly young adults ages 18 to 40 (56.28%). Parkinsonism was the prevalent clinical manifestation of EPS. Among the first-generation antipsychotics (FGAs), haloperidol injection and haloperidol decanoate injection posed the highest risk to EPS. Among the second-generation antipsychotics (SGAs), risperidone microspheres for injection, paliperidone palmitate injection, ziprasidone tablets, risperidone tablets/oral solution, and paliperidone extended-release tablets were associated with the highest risk. The latency period for EPS ranged from hours to years. Conclusion EPS induced by both SGAs and FGAs deserves equal clinical attention. Close monitoring of EPS throughout antipsychotic treatment is essential to safety and effectiveness of medications.

Key words: Antipsychotics, Haloperidol Injection, Haloperidol Decanoate Injection, Risperidone Microspheres for Injection, Paliperidone Palmitate Injection, Defined Daily Doses, Extrapyramidal Symptoms, Adverse Drug Reaction

CLC Number:

R971
R994.11

LAN Xiaoqian, ZHUANG Hongyan, LI Pengfei. Clinical Characteristics of 183 Reports of Extrapyramidal Symptoms Induced by Antipsychotics[J]. Chinese Journal of Pharmacovigilance, 2026, 23(1): 101-104.

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https://zgywjj.magtechjournal.com/EN/Y2026/V23/I1/101

References

[1] DIVAC N, PROSTRAN M, JAKOVCEVSKI I, et al.Second-Generation Antipsychotics and Extrapyramidal Adverse Effects[J]. Biomed Res Int, 2014, 2014: 656370.
[2] FORNARO M, MIOLA A, DEBERARDIS D, et al.Perspectives on Precision Psychiatry Using Antipsychotics in the Management of Bipolar Disorder[J]. Brain Sciences, 2025, 15(5): 430.
[3] AUBRY R, HASTINGS T, MORGAN M,et al.Guideline Concordant Screening and Monitoring of Extrapyramidal Symptoms in Patients Prescribed Antipsychotic Medication: a Protocol for a Systematic Literature Review and Narrative Synthesis[J]. BMJ Open, 2024, 14(9): e087632.
[4] LINDGREN M, THERMAN S, AVELLAN A, et al.Extrapyramidal Symptoms Predict Cognitive Performance after First-Episode Psychosis[J]. Schizophrenia (Heidelb), 2022, 8(1): 64.
[5] MONTELEONE P, CASCINO G, MONTELEONE AM, et al.Prevalence of Antipsychotic-Induced Extrapyramidal Symptoms and Their Association with Neurocognition and Social Cognition in Outpatients with Schizophrenia in the "Real-Life"[J]. J Clin Psychopharmacol, 2022, 42(5): 475-479.
[6] LU L, LI T, WANG GH.Shorter Oxford Textbook of Psychiatry(牛津精神病学)[M]. 7th ed. Beijing: Peking University Medical Press, 2022.
[7] MONTELEONE P, CASCINO G, ROSSI A, et al.Evolution of Antipsychotic-Induced Extrapyramidal Symptoms in Patients with Schizophrenia in the Real-Life: a 4-Year Follow-up Naturalistic Study[J]. Schizophrenia Research, 2022, 248: 279-286.
[8] ABU-NASER D, GHARAIBEH S, ALMESLAMANI AZ, et al.Assessment of Extrapyramidal Symptoms Associated with Psycho-tropics Pharmacological Treatments, and Associated Risk Factors[J].Clin Pract Epidemiol Ment Health, 2021, 17(1): 1-7.
[9] CAROFF SN, MANN SC, CAMPBELL EC, et al.Movement Disorders Associated with Atypical Antipsychotic Drugs[J]. J Clin Psychiatry, 2002, 63( Suppl 4): 12-19.
[10] GLAZER WM. Extrapyramidal Side Effects, Tardive Dyskinesia,the Concept of Atypicality[J]. J Clin Psychiatry, 2000, 61(Suppl 3): 16-21.
[11] MILLER DD, CAROFF SN, DAVIS SM, et al.Extrapyramidal Side-Effects of Antipsychotics in a Randomised Trial[J]. Br J Psychiatry, 2008, 193(4): 279-288.
[12] KADAKIA A, BRADY BL, DEMBEK C, et al.The Incidence and Economic Burden of Extrapyramidal Symptoms in Patients with Schizophrenia Treated with Second Generation Antipsychotics in a Medicaid Population[J]. J Med Econ, 2022, 25(1): 87-98.
[13] SAGA Y, CHIANG CL, WAKAMATSU A.A Descriptive Analysis of Spontaneous Reports of Antipsychotic-Induced Tardive Dyskinesia and Other Extrapyramidal Symptoms in the Japanese Adverse Drug Event Report Database[J]. Neuropsychopharmacol Rep, 2024, 44(1):221-226.
[14] ZHAND N, LABELLE A, GHANEM D, et al.Comparison of Extra-pyramidal Symptoms among Outpatients with Schizophrenia on Long-Acting Injectable Antipsychotics[J]. Antipsychotics,J Clin Psychopharmacol, 2022, 42(5): 475-479.
[15] WANG G, MAO FQ.Psychiatry(精神病学)[M]. 5th ed. Beijing: Peking University Medical Press, 2024.
[16] LIU DT, SI TM, KUANG L, et al.Recommendations on Clinical Application of Deutetrabenazine for Treatment of Tardive Dyskinesia[J]. Chinese Journal of Nervous and Mental Diseases(中国神经精神疾病杂志), 2025, 51(2): 65-71.