Peter R. Breggin, M.D.
$ 6.7 million awarded
in Risperdal tardive dyskinesia case
On May 26, 2000, a jury in the circuit
court of Philadelphia awarded $ 6.7 million to a patient afflicted
with tardive dyskinesia caused by the neuroleptic ("antipsychotic")
drug Risperdal (generic name, risperidone). In Liss vs. Doeff,
the jury found the psychiatrist negligent in his treatment of Mrs.
Elizabeth Liss. The case is among the first involving Risperdal,
a relatively new neuroleptic that was put on the market in 1994
and originally promoted as relatively free of the risk of tardive
dyskinesia. Peter R. Breggin, M.D., referred the case to the attorneys
and acted as a medical consultant throughout the case.
Ms. Liss developed tardive dyskinesia during
a fourteen-month period of exposure to Risperdal as a maintenance
treatment for manic-depressive (bipolar) disorder. In previous
years, she had several relatively brief exposures to other neuroleptics.
Tardive dyskinesia is a movement
disorder caused by neuroleptic or "antipsychotic" medications.
It can afflict any voluntary muscles of control. It can become
severe and disabling, and there are no effective treatments.
Studies of older neuroleptics such as Haldol, Navane, Prolixin,
and Thorazine have demonstrated a cumulative risk of 4%-8% per year
for the development of this disorder. Thus, the risk developing
tardive dyskinesia during a five-year exposure to neuroleptics is
in the astronomical range of 20%-40%. Among the elderly
cumulative rates can surpass 20% per year. Tardive dyskinesia
also afflicts children.
As yet there is insufficient data to predict
the exact rates of tardive dyskinesia for newer, atypical neuroleptics
such as Risperdal, Zyprexa (olanzapine), and Seroquel (quetiapine).
However, prudent physicians should assume that all neuroleptic drugs
are associated with a high risk of tardive dyskinesia.
Mrs. Liss suffered from a form of tardive
dyskinesia called tardive dystonia. The dystonia caused Mrs.
Liss to suffer from disfiguring facial grimaces and painful neck
spasms. In addition, she was afflicted with abnormal movements
of her tongue, jaw, and mouth, impaired swallowing, occasionally
irregular breathing, and abnormalities in her hands and walking.
The case was significant in regard to the
large award of $ 6.7 million for a patient who was not completely
disabled. Although requiring frequent periods of rest, and
experiencing disfigurement and physical discomfort, she was able
to carry out household tasks and to work outside the home.