[Recent research trends in diagnosis, treatment, and prevention of drug-induced extrapyramidal symptoms seen in psychiatric patients].

Extrapyramidal symptoms (EPS) induced by neuroleptics (NLP) are still one of the major clinical problems in treating psychiatric patients. The reliability of the drug-induced extrapyramidal symptoms scale (DIEPSS) and the Japanese version of Barnes Akathisia Scale has recently been established, and these scales are used in the clinical psychopharmacological studies performed in Japan. One of the recent research trends of the epidemiological studies on tardive dyskinesia (TD) is characterized by the prospective longitudinal design with older subjects. Although no effective treatment for TD has yet been established, the efficacy of vitamin E for TD has been tested in the USA, while an open clinical trial of rolipram was recently performed in Japan. One of the preventive studies for TD, searching for genetic variations that could act as a marker to identify especially vulnerable patients to TD, is now being conducted by our research group. It is believed that the use of clozapine, an atypical antipsychotic drug, or a serotonin-dopamine antagonist such as risperidone will leave patients free of EPS, however, the real value of these drugs in terms of the effect of reducing EPS, including TD, in Japanese patients requires further evaluation.