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Talk:Extrapyramidal symptoms: Difference between revisions
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*'''Muscle contractions''' - Uncontrolled and severe contractions can occur in | '''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. | ||
*''' | ==Symptoms== | ||
*'''Muscle contractions''' - Uncontrolled and severe contractions can occur in the head, neck, and limbs and may cause a stiff tongue, arched back, or twisted neck. Another sign is that the patient/victim finds it very difficult to talk, sometimes having the mouth "locked open." | |||
*Continuous '''[[muscle spasms]]''' | |||
*'''Restlessness''' - This can include nervous energy such as pacing or tapping one's foot. | *'''Restlessness''' - This can include nervous energy such as pacing or tapping one's foot. | ||
*'''Decreased bodily movement''' | *'''Decreased bodily movement''' | ||
*'''[[Tremors]]''' | *'''[[Tremors]]''' | ||
*'''Stiff posture''' - This can include the lack of arm movement when walking. | *'''Stiff posture''' - This can include the lack of arm movement when walking. | ||
*Tardive dyskinesia (irregular, jerky movements).<ref>Pierre, J. M. (2005). Extrapyramidal Symptoms with Atypical Antipsychotics. Drug Safety, 28(3), 191–208. https://doi.org/10.2165/00002018-200528030-00002</ref> | *Tardive or acute dyskinesia (irregular, jerky movements).<ref>Pierre, J. M. (2005). Extrapyramidal Symptoms with Atypical Antipsychotics. Drug Safety, 28(3), 191–208. https://doi.org/10.2165/00002018-200528030-00002</ref> | ||
*'''Uncontrolled movements''' - This may include uncontrolled movements of the tongue, jaw, lips, fingers, toes, or face, such as pursing one's lips, chewing, frequently blinking one's eyes, nodding one's head, or pelvic thrusting. | **'''Uncontrolled movements''' - This may include uncontrolled movements of the tongue, jaw, lips, fingers, toes, or face, such as pursing one's lips, chewing, frequently blinking one's eyes, nodding one's head, or pelvic thrusting. | ||
*'''[[Irregular breathing]]''' - This may include grunts, gasping, or | *'''[[Irregular breathing]]''' or '''[[Respiratory depression|respiratory arrest]]''' - This may include grunts, gasping, sighing, or, in severe cases, the complete absence of breathing. | ||
*'''Weak voice''' | *'''Weak voice''' or '''thick speech''' - The muscles in the mouth and throat as well as the face are likely too contracted and weakened to properly form sound. | ||
*'''[[Salivation]]''' | *'''[[Salivation]]''' | ||
*'''Lack of facial expression''' | *'''Lack of facial expression''' | ||
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==Treatment== | ==Treatment== | ||
[[File:Akineton Advertisement, 1966.jpg|400px|thumbnail|right|Advertisement for Akineton (biperiden).]] | |||
[[Acetylcholine|Anticholinergic]] drugs are used to control neuroleptic-induced EPS, although akathisia may require beta blockers or even [[benzodiazepines]]. If the EPS are induced by an [[antipsychotic]], EPS may be reduced by dose [[Tapering|titration]] or by switching to an atypical [[antipsychotic]], such as aripiprazole, ziprasidone, [[quetiapine]], olanzapine, [[risperidone]], or clozapine. | [[Acetylcholine|Anticholinergic]] drugs are used to control neuroleptic-induced EPS, although akathisia may require beta blockers or even [[benzodiazepines]]. If the EPS are induced by an [[antipsychotic]], EPS may be reduced by dose [[Tapering|titration]] or by switching to an atypical [[antipsychotic]], such as aripiprazole, ziprasidone, [[quetiapine]], olanzapine, [[risperidone]], or clozapine. | ||
Commonly used medications for EPS are [[acetylcholine|anticholinergic]] agents such as benztropine (Cogentin), [[diphenhydramine]] (Benadryl), and trihexyphenidyl (Artane). Another common course of treatment includes [[dopamine]] [[agonist]] agents such as pramipexole. 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 biperiden (Akineton), benztropine (Cogentin), [[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. | ||
==See also== | ==See also== | ||
*[[Antipsychotics]] | *[[Antipsychotics]] | ||
**[[Haloperidol]], one of the most common agents associated with EPS | |||
**[[Risperidone]], another agent known to induce EPS | |||
*[[Responsible drug use]] | *[[Responsible drug use]] | ||
*[[Dopamine]] | *[[Dopamine]] | ||
==Citations== | ==Citations== | ||