Cervical dystonia and substance abuse (P5.061)

Objective: To investigate the prevalence of substance abuse (SA) in patients with cervical dystonia (CD) and to correlate it with prevalence of psychiatric disorders. Background: CD patients have a higher frequency of psychiatric disorders compared to healthy controls. Medications such as benzodiazepines, muscle relaxants and opiates are often used in the management of CD and are habit-forming which raises concern for abuse. Design/Methods: Data on anxiety, depression, dystonia severity and substance abuse was collected from 10 sites participating in the Dystonia Coalition. Patients were divided into two groups according to the presence of SA, utilizing Structured Clinical Interview for DSM-4 (SCID) criteria. Wilcoxon Rank-Sum test was used to analyze the difference in median scores on the questionnaires between the groups. Chi square test was used to analyze association between opiate and benzodiazepine use and SA. A two-tailed p-value of Results: Of 208 CD patients, 23 (11%) were identified with SA; 26.3% of patients with SA were on opiates compared to 7.2% of CD patients without SA (p = 0.006). Compared to non-SA patients those experiencing SA were more likely male (88.9%; p= 0.0007), younger (median age 55; p= 0.031), and scored worse on questionnaires assessing depression (p = 0.044, p = 0.005), anxiety (P = 0.003), and dystonia psychiatric severity (P = 0.033). Conclusions: Potential risk factors for SA in CD patients include younger age and male gender with co-morbid anxiety, depression, and other psychiatric problems. Caution should be exercised when prescribing drugs with potential for abuse in these patients. Study Supported by: This study was supported in part by the Dystonia Coalition, which is funded by the National Center for Advancing Translational Sciences (grant U54 TR001456) and the National institute for Neurological Disorders and Stroke (U54 NS065701) at the National Institutes of Health, USA. Disclosure: Dr Mahajan has nothing to disclose. Dr. Jankovic has nothing to disclose. Dr. Marsh has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Jinnah has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan. Dr. Comella has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Merz Pharmaceutical, Revance Therapeutic, Retrophin Therapeutic. She receives compensation/honoraria for services as a consultant or an advisory committee member: Acorda Therapeutics, Allergan, Inc;; Lundbeck Ltd.;Medtronic Inc.; Merz Pharmaceuticals;Acadia Pharmaceuticals; Jazz Pharmaceuticals, Neurocrine Biosciences Inc., Revance Therapeutic. She receives royalties from Cambridge, Wolters Kluwer. . Dr. Barbano has nothing to disclose. Dr. Perlmutter has received personal compensation in an editorial capacity for Dr. Joel Perlmutter has support from NIH (NINDS, NIA), CHDI, APDA, Greater St. Louis Chapter of the APDA, MJ Fox Foundation, Barnes-Jewish Hospital Foundation. Dr. Patel has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Dr. Neepa Patel has received honoraria as a consultant for Acadia pharmaceuticals and as a speaker for Teva pharmaceuticals.