Dean, Charles E., M.D.

PSYCHIATRY

I am an investigator on several studies of antipsychotic drugs. In one study, we are comparing the 12 month outcome of 2 antipsychotic drugs with regard to any effect on mortality or development of diabetes. In another, we will be comparing 2 other antipsychotic drugs on the development of cataracts in patients followed for 2 years. We are part of a national network of hospitals and clinics investigating these issues. We have completed a study of 100 patients seen in a movement disorders clinic in psychiatry. Our aim was to compare the usual clinical ratings of abnormal, involuntary movements with more objective measurements using instruments that can measure even small degrees of movements. We found that 62% of patients had tardive dyskinesia, or TD (a movement disorder caused by antipsychotic drugs), when evaluated with instruments versus some 27% when evaluated with standard clinical rating scales. This study is due to be published in 2004 in Journal of Clinical Psychopharmacology. We are preparing a followup paper as well, looking at predictors of TD and other issues. We are currently analyzing data on 1400 patients seen in our TD clinic with the goal of establishing whether TD carries an increased mortality rate. Many of these patients have been followed for at least 10 years. The analysis is not complete, but at this point it appear that TD is associated with approximately a 35% higher mortality rate. We have used the National Death Index to gather solid information on mortality and causes of death, never before done in studies on TD mortality. We believe this study will finally settle the long debate over TD and mortality. I am currently preparing a paper on the cellular effects of antipsychotic drugs, and whether these effects are toxic, therapeutic, or both. I am the PI on a funded, randomized controlled trial of gabapentin in the treatment of antipsychotic-induced tremor.