TARDIVE-DYSKINESIA AND SERUM IRON INDEXES

Background: This study was undertaken to evaluate whether peripheral ( serum) markers of iron status are associated with severity of the chor eoathetoid movements seen in tardive dyskinesia (TD). Methods: Serum i ron indices (ferritin, iron, and total iron binding capacity) and flup henazine levels were measured in a group of 30 male DSM-III diagnosed schizophrenic patients chronically treated with fluphenazine decanoate . The severity of choreoathetoid movements was assessed with the Abnor mal Involuntary Movement Scale (AIMS), and akathisia was assessed with the Barnes scale. Results: A significant positive correlation was obs erved between AIMS scores and serum ferritin. This relationship remain ed significant after controlling for age and plasma fluphenazine level s. No significant correlations were observed between serum iron or tot al iron binding capacity and choreoathetoid movement ratings. There we re no significant associations between serum iron indices and akathisi a ratings. Conclusions: The data suggest that choreoathetoid movements are associated with serum ferritin levels in chronically medicated ma le schizophrenic patients. This relationship does not seem to be cause d by an association of these variable with age or plasma fluphenazine levels, in addition, the relationship seems to be specific, since othe r iron indices and another extrapyramidal side effect (akathisia) do n ot demonstrate a similar relationship. In view of reports that antipsy chotic medications change normal iron metabolism and increase iron upt ake into the brain, the current results could be interpreted to sugges t that serum ferritin levels may be a risk factor for TD in patients t reated with ''classic'' antipsychotic medications. Published 1998 Soci ety of Biological Psychiatry.