Treatment of acute neuroleptic-induced movement disorders.
Acute extrapyramidal syndromes (EPS), including dystonia, parkinsonism, and akathisia, are associated with the use of virtually all neuroleptic agents. They may be alleviated by reducing the neuroleptic dosage, switching to a lower-potency drug, or administering an adjunctive agent such as an anticholinergic, amantadine, benzodiazepine, or beta-blocker. Akathisia may be only partly dispelled by anticholinergics; alternatives are beta-blockers, benzodiazepines, and clonidine. In patients receiving long-term neuroleptic therapy, both the prophylactic use and the duration of treatment with concomitant anti-EPS drugs are controversial. Administration of prophylactic anti-EPS drugs should be based on the likelihood that the patient will develop EPS, as well as the risk of adverse reactions resulting from extended use of the agents in a specific patient. The decision to continue anti-EPS therapy should be reevaluated frequently, especially in elderly patients.
Tonda
M E
ME
Department of Pharmacy Services, University of Michigan Medical Center, Ann Arbor.
Guthrie
S K
SK
D000208:Acute Disease; D017109:Akathisia, Drug-Induced / Q000188:drug therapy / Q000209:etiology; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001480:Basal Ganglia Diseases / Q000139:chemically induced* / Q000503:physiopathology; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use; D004421:Dystonia / Q000139:chemically induced / Q000188:drug therapy; D006801:Humans; D010302:Parkinson Disease, Secondary / Q000139:chemically induced / Q000188:drug therapy
D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists; D015259:Dopamine Agents