Absence of neuroleptic-induced parkinsonism in psychotic patients receiving adjunctive electroconvulsive therapy.

The presence of movement disorders was ascertained blind to treatment status in 35 schizophrenic patients. All were on neuroleptics and receiving, or had received earlier during the index episode, adjunctive bilateral electroconvulsive therapy (ECT). None manifested signs of neuroleptic-induced parkinsonism (rigidity, bradykinesia, or abnormal gait). Fine tremor of the hands was noted in two patients, and only one met criteria for probable mild tardive dyskinesia. The implications of these findings for understanding neurological complications associated with schizophrenia and its treatment with ECT are discussed. The hypothesis is proposed that ECT protects against neuroleptic-induced parkinsonism and thereby may reduce the risk for the subsequent development of tardive dyskinesia.