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Talk:Extrapyramidal symptoms: Difference between revisions
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[[File:Four types of EPS.png|275px|thumbnail|right|An image that quickly summarizes the four types of extrapyramidal symptoms with illustrations.]] | |||
'''Extrapyramidal symptoms''' (EPS), also known as '''extrapyramidal side effects''' (EPSE), are drug-induced movement disorders that include acute and tardive/chronic symptoms. They are mainly caused by the blockade of dopamine at dopaminergic receptors. | '''Extrapyramidal symptoms''' (EPS), also known as '''extrapyramidal side effects''' (EPSE), are drug-induced movement disorders that include acute and tardive/chronic symptoms. They are mainly caused by the blockade of dopamine at dopaminergic receptors. | ||
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===Acute dystonia=== | ===Acute dystonia=== | ||
Acute dystonia is a painful and often severe type of extrapyramidal symptoms that occurs shortly (within less than a day) after the administration of an [[dopamine|antidopaminergic]] agent. | [[File:Medication-induced dystonia.JPG|275px|thumbnail|right|A patient experiencing acute dystonia caused by a dopamine-blocking medication.]] | ||
Acute dystonia is a painful and often severe type of extrapyramidal symptoms that occurs shortly (within less than a day){{citation needed}} after the administration of an [[dopamine|antidopaminergic]] agent. | |||
[[Muscle spasms|Continuous muscle contractions]] can occur in the head, neck, and limbs and may cause a stiff tongue, arched back, or twisted neck. | [[Muscle spasms|Continuous muscle contractions]] can occur in the head, neck, and limbs and may cause a stiff tongue, arched back, or twisted neck. Dystonia also includes a lack of ability to move muscle and low muscle tone. | ||
Treatment of acute dystonia is often an anticholinergic agent and/or a benzodiazepine.{{citation needed}} | |||
===Akathisia=== | ===Akathisia=== | ||
Akathisia is characterized by restlessness, a need to move, constant sitting down and standing up, pacing, etc. Treatments for akathisia are anticholinergics, beta blockers, or [[benzodiazepines]]. Akathisia typically develops some time during a medication regimen | Akathisia is characterized by restlessness, a need to move, constant sitting down and standing up, pacing, etc. Treatments for akathisia are anticholinergics, beta blockers, or [[benzodiazepines]]. Akathisia typically develops some time during a medication regimen{{citation needed}} | ||
===Psuedoparkinsonism=== | ===Psuedoparkinsonism=== | ||
Psuedoparkinsonism occurs often further than akathisia. It is often noticed by seeing: | Psuedoparkinsonism occurs often further than akathisia.{{citation needed}} It is often noticed by seeing: | ||
*tremoring hands in a "pill-rolling" pose, | *tremoring hands in a "pill-rolling" pose, | ||
*a stooped posture, | *a stooped posture, | ||
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and others. Others also include that when the person turns, they must do so very slowly and sometimes cannot change positions, such as standing to sitting, without a support. | and others. Others also include that when the person turns, they must do so very slowly and sometimes cannot change positions, such as standing to sitting, without a support. | ||
===Tardive dyskinesia=== | ===Tardive dyskinesia=== | ||
This disorder develops over long periods of time and is noticed by these signs: involuntary chewing, lip smacking or sucking, twitching, and/or involuntary movements of the limbs that are often jerky. It is treated by putting the a dopaminergic | This disorder develops over long periods of time{{citation needed}} and is noticed by these signs: involuntary chewing, lip smacking or sucking, twitching, and/or involuntary movements of the limbs that are often jerky. It is treated by putting the patient on a dopaminergic medication regimen, such as using valbenzaine, tetrabenazine, ropinirole, or pramipexole. | ||
==Causes== | ==Causes== | ||
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Other antidopaminergic drugs, like the [[Nausea suppression|antiemetic]] metoclopramide, can also result in extrapyramidal side effects.<ref>Moos, D. D., & Hansen, D. J. (2008). Metoclopramide and Extrapyramidal Symptoms: A Case Report. Journal of Perianesthesia Nursing, 23(5), 292–299. https://doi.org/10.1016/j.jopan.2008.07.006</ref> | Other antidopaminergic drugs, like the [[Nausea suppression|antiemetic]] metoclopramide, can also result in extrapyramidal side effects.<ref>Moos, D. D., & Hansen, D. J. (2008). Metoclopramide and Extrapyramidal Symptoms: A Case Report. Journal of Perianesthesia Nursing, 23(5), 292–299. https://doi.org/10.1016/j.jopan.2008.07.006</ref> | ||
Short and long-term use of antidepressants such as selective serotonin reuptake inhibitors ([[SSRI]]), serotonin-norepinephrine reuptake inhibitors (SNRI), and norepinephrine-dopamine reuptake inhibitors (NDRI) | Short and long-term use of antidepressants, such as selective serotonin reuptake inhibitors ([[SSRI]]), serotonin-norepinephrine reuptake inhibitors (SNRI), and norepinephrine-dopamine reuptake inhibitors (NDRI) has also resulted in extrapyramidal symptoms. Specifically, duloxetine, sertraline, escitalopram, fluoxetine, and bupropion have been linked to the induction of extrapyramidal symptoms.<ref>Madhusoodanan, S., Alexeenko, L., Sanders, R., & Brenner, R. (2010). Extrapyramidal symptoms associated with antidepressants--a review of the literature and an analysis of spontaneous reports. Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists, 22(3), 148–56. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20680187</ref> | ||
==Treatment== | ==Treatment== | ||
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Commonly used medications for EPS are [[acetylcholine|anticholinergic]] agents such as benztropine (Cogentin), biperiden (Akineton), [[diphenhydramine]] (Benadryl), and trihexyphenidyl (Artane). Another common course of treatment includes [[dopamine]] [[agonist]] agents, such as pramipexole and ropinirole. These medications reverse the symptoms of extrapyramidal side effects caused by [[antipsychotics]] or other drugs that either directly or indirectly inhibit [[Dopamine|dopaminergic]] neurotransmission. | Commonly used medications for EPS are [[acetylcholine|anticholinergic]] agents such as benztropine (Cogentin), biperiden (Akineton), [[diphenhydramine]] (Benadryl), and trihexyphenidyl (Artane). Another common course of treatment includes [[dopamine]] [[agonist]] agents, such as pramipexole and ropinirole. These medications reverse the symptoms of extrapyramidal side effects caused by [[antipsychotics]] or other drugs that either directly or indirectly inhibit [[Dopamine|dopaminergic]] neurotransmission. | ||
==Literature== | |||
==External links== | |||
[https://en.wikipedia.org/wiki/Extrapyramidal_symptoms Extrapyramidal symptoms (Wikipedia)] | |||
==See also== | ==See also== | ||
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*[[Dopamine]] | *[[Dopamine]] | ||
==References== | ==References== | ||
[[Category:Approval]] | |||