Extrapyramidal symptoms and residual psychopathology with low-dose neuroleptics

Residual psychopathology associated with EPS has bean mainly assessed in ex perimental studies where neuroleptics were administered at standard, fixed dosages. The present study evaluates residual psychopathology in 69 schizop hrenic patients treated with moderate, flexible doses of neuroleptics (430 mg eq. CPZ) at the out-patient Community Mental Health Services (CMHSs) in Bologna. Akathisia was present in 27.5 per cent of patients and parkinsonis m in 27.5 per cent. A more severe psychopathological state was associated w ith both side-effects, as seen by significantly higher BPRS global scores. This severity was due to tension and anxiety-depression symptoms in patient s with akathisia and to negative symptomatology in patients with parkinsoni sm, as shown by significant associations with BPRS subscales ANS-DEP and NE G, respectively. In conclusion, the present study underlines that EPS are f requent even in an out-patient setting where moderate neuroleptic doses are employed, and more importantly shows that in these conditions, the residua l psychopathology resulting from EPS is clinically very significant. Copyri ght (C) 2000 John Wiley & Sons, Ltd.