Extrapyramidal symptoms during antipsychotic treatment Review article
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Abstract
The extrapyramidal system can be affected in a number of ways, which are revealed in a range of extrapyramidal symptoms (EPS), such as akinesia (inability to initiate movement) and akathisia (inability to remain motionless). EPS can be also induced by the antipsychotic treatment that is related to some specific extrapyramidal conditions, such as acute dystonic reactions and tardive dyskinesia. Prominent EPS were common in classical antipsychotic era. Unfortunately, many newer atypical antipsychotics can also induce subclinical or evident EPS. Anticholinergic drugs (like biperiden) and dopaminergic drugs (like amantadine) are most frequently used to control neuroleptic-induced EPS. Some of them can be administered intravenously in emergent conditions (amantadine, biperiden). Two most complex clinical reactions, i.e. subclinical akathisia and tardive akathisia may require some other activities and additional medicines, like special dose titration, switching to other atypical antipsychotics, administration of beta-blockers, benzodiazepines, and other drugs.
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