PSYCHOSIS + SCHIZOPHRENIA: SIDE EFFECTS

Question 1

What are extra-pyrimidal side-effects?

Answer 1

1. Parkinsonian symptoms
   - Tremor, rigidity, bradykinesia
   - Common elderly females
   - Occurs gradually
2. Dystonia
   - uncontrolled muscle spasm in any part of the body
   - Abnormal face and body movements
   - Most likely in young males
   - Can occur within hours of starting treatment
3. Akathisia
   - Restlessness
   - Inner desire to move feet etc.
4. Tardive dyskinesia
   - rhythmic, involuntary
   movement of tongue, face and jaw

Question 2

Parkinsonian symptoms

Answer 2

• Tremor, rigidity, bradykinesia
• Common elderly females
• Occurs gradually

Question 3

Dystonia

Answer 3

• uncontrolled muscle spasm in any part of the body
• Abnormal face and body movements
• Most likely in young males
• Can occur within hours of starting treatment

Question 4

Akathisia

Answer 4

• Restlessness
• Inner desire to move feet etc.

Question 5

Tardive dyskinesia

Answer 5

• rhythmic, involuntary
  movement of tongue, face and jaw

Question 6

What can be given in conjunction with antipsychotics to reduce the EPSES?

Answer 6

Antimuscarinics - may mask or worsen tardive dyskinesia
- Proyclidine
- Orphenadine
- Trihexyphenidyl

Question 7

What is the best way to reduce EPSES

Answer 7

• Lower dose
• Switch to 2nd gen APs

Question 8

Why do EPSEs occur with typical APs

Answer 8

• Typical APs work by blocking D2 receptors in the brain and thus decrease dopamine levles
• PD thought to be caused by low dopamine, these pt require dopamine to lessen symptoms
• Decrease in dopamine by typical APs = EPSEs