title: Treatment of acute neuroleptic-induced movement disorders.
abstract: 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.
authors.affiliation: Department of Pharmacy Services, University of Michigan Medical Center, Ann Arbor.
authors.forename: M E
authors.initials: ME
authors.lastname: Tonda
authors.forename: S K
authors.initials: SK
authors.lastname: Guthrie
mesh_terms: 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
chemical_list: D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists; D015259:Dopamine Agents