NEUROLEPTIC-RELATED DYSKINESIAS IN AUTISTIC-CHILDREN - A PROSPECTIVE,LONGITUDINAL-STUDY

Objective: To report results from a long-term prospective study of saf ety of haloperidol treatment and prevalence of haloperidol-related dys kinesias. Method: Subjects were children with autism requiring pharmac otherapy for target symptoms. After baseline assessments, children rec eived haloperidol treatment; responders requiring further treatment we re considered for enrollment into the present study. Six-month haloper idol treatment periods were followed by a 4-week placebo period. The p rocedure was repeated if further haloperidol treatment was required. A t specified times children were evaluated by using multiple instrument s. Results: Between 1979 and 1994, 118 children aged 2.3 to 8.2 years participated in the study. The mean dose of haloperidol was 1.75 mg/da y. Mainly withdrawal dyskinesias (WD) developed in 40 (33.9%) children ; 20 had more than one dyskinetic episode. A subgroup that remained si gnificantly longer in the study and had a significantly higher cumulat ive dose of haloperidol evidenced a significantly higher incidence of WD. Occurrence rates of tardive dyskinesia (TD) and multiple episodes of TD/WD were higher among girls. Conclusion: Female gender and pre- a nd perinatal complications may be involved in susceptibility to dyskin esias; greater cumulative haloperidol dose and/or longer exposure to h aloperidol may increase the risk.