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Extrapyramidal side effects as a consequence of treatment with neuroleptics
Einstein
To check the occurrence of extrapyramidal side effects in patients receiving neuroleptic drugs, how these effects are treated, and to observe the occurrence of hallucinations caused by treatment of extrapyramidal symptoms. Methods: The present study analyzed medical records and interviewed 39 schizophrenic patients being treated in a public primary care clinic located in the southern part of the city of São Paulo, who had previously agreed to participate in the project. results: Among 39 patients studied, 85% presented extrapyramidal symptoms. Of these, 69.7% were treated for the side effects, 73.9% were treated with biperiden and 26.09% had their neuroleptic drug reduced. Out of those patients treated with biperiden, 70.5% had side effects, such as hallucination and delusion, blurred vision, somnolence and verbal memory deficit. conclusions: The majority of patients (85%) undergoing treatment with neuroleptic drugs developed motor side effects. When these extrapyramidal symptoms were treated with central action anticholinergic drugs (biperiden), hallucination and/or delusion occurred in 52.94% of patients -probably because of increased dopaminergic activity as a consequence of cholinergic activity reduction caused by biperiden in the mesocortical and mesolimbic pathways.
To check the occurrence of extrapyramidal side effects in patients receiving neuroleptic drugs, how these effects are treated, and to observe the occurrence of hallucinations caused by treatment of extrapyramidal symptoms. Methods: The present study analyzed medical records and interviewed 39 schizophrenic patients being treated in a public primary care clinic located in the southern part of the city of São Paulo, who had previously agreed to participate in the project. results: Among 39 patients studied, 85% presented extrapyramidal symptoms. Of these, 69.7% were treated for the side effects, 73.9% were treated with biperiden and 26.09% had their neuroleptic drug reduced. Out of those patients treated with biperiden, 70.5% had side effects, such as hallucination and delusion, blurred vision, somnolence and verbal memory deficit. conclusions: The majority of patients (85%) undergoing treatment with neuroleptic drugs developed motor side effects. When these extrapyramidal symptoms were treated with central action anticholinergic drugs (biperiden), hallucination and/or delusion occurred in 52.94% of patients -probably because of increased dopaminergic activity as a consequence of cholinergic activity reduction caused by biperiden in the mesocortical and mesolimbic pathways.
The impact of neuroleptic dosage and extrapyramidal side effects on schizophrenic basic symptoms
Comprehensive Psychiatry, 2000
The impact of neuroleptic medication and extrapyramidal symptoms on abnormal subjective experiences in schizophrenia, also termed basic symptoms, as assessed with the Frankfurt Complaint Questionnaire (FCQ) was investigated in 40 schizophrenic patients medicated with conventional neuroleptics. Basic symptoms are thought to reflect the subjective side of schizophrenic vulnerability and to underlie schizophrenic symptomatology. It was expected that basic symptoms would inversely correlate with chlorpromazine equivalents, since neuroleptics not only improve acute schizophrenic symptoms but also have prophylactic properties. However, a significant positive correlation with neuroleptic dosage and extrapyramidal symptoms emerged, suggesting that basic symptoms as operationalized in the FCQ partly reflect neurolepticinduced deficits. The results remained unchanged when global psychopathology was controlled for. In line with previous research, basic symptoms correlated with thought disorder but not with positive symptoms. However, when the effects of neurolepticinduced disturbances were controlled for, thought disorder also insignificantly correlated with basic symptoms. Our findings confirm previous results that question the construct validity of the FCQ. Moreover, the need to control for confounding variables (such as medication) is emphasized by comparing different psychiatric groups.
Extrapyramidal Symptoms and Novel Antipsychotic Drugs
International Neuropsychiatric Disease Journal
One of the challenges of antipsychotic medication is the occurrence of Extrapyramidal Symptoms. These cannot be easily eliminated considering the pathophysiology of schizophrenia and the established mechanism of action of classical antipsychotics. The antipsychotics help improve symptoms of schizophrenia by binding to dopamine receptors in the central nervous system and blocking dopamine. This prevents the basal ganglia from getting enough dopamine. Many drugs used in the treatment of mental disorders such as the neuroleptics and antidepressants adversely affect extrapyramidal system function, resulting in symptoms such as tremors and muscle rigidity collectively known as extrapyramidal symptoms. Treatment generally involves lowering the dose or trying a different antipsychotic but drugs may also be used specifically to treat symptoms. This review examines the attempt to eliminate extrapyramidal symptoms by generations of antipsychotic medications and their comparative efficacy in t...
Archives of psychiatry research, 2023
Background: Antipsychotic medication for the treatment of schizophrenia spectrum disorders are associated with adverse effects with extrapyramidal side effects constituting one of the most notable effects associated with poor medication adherence and poor quality of life. Aims: The study aims to compare the prevalence of extrapyramidal side effects (EPSE), among patients with schizophrenia spectrum disorders on typical and atypical antipsychotic medications. The secondary aim is to determine the association of extra-pyramidal side effects with socio-clinical variables. Methodology: A cross-sectional hospital-based study with systematic random sampling recruitment of 340 participants and 303 completed the study. Variables with significant association on chi square analysis were subjected to logistic regression analysis. Results: The overall prevalence of extrapyramidal side effects among patients with schizophrenia spectrum disorder on antipsychotic medication was 42.6 %. The prevalence of tardive dyskinesia, parkinsonism and akathisia were 7.9 %, 38.6 and 3.6 %, respectively. The prevalence of extra-pyramidal side effects due to use of typical, atypical and combination drug was 44.4 %, 51.2 % and 34.5 %, respectively with haloperidol (59.4 %) and risperidone (71.4 %) having the greatest effect. Being elderly was associated with tardive dyskinesia, duration of treatment, severity of illness and type of illness with parkinsonism and severity of illness with akathisia. Conclusion: The findings of this study support the high prevalence of extrapyramidal side effects from either using typical and atypical antipsychotic medications. Therefore, Clinicians should discuss on these side effects and proffer possible solutions with their patients prior to commencement of antipsychotic medications in order to promote medication adherence.
European Psychiatry, 1999
Cognitive impairments in schizophrenics have been found to precede tardive dyskinesia and to co-exist with other motor deficits. However, little is yet known about the prevalence of cognitive disturbances in patients with neuroleptic-induced parkinsonism. From the literature on idiopathic parkinson, it was inferred that extrapyramidal symptoms (EPS) are accompanied by cognitive dysfunction. 85 schizophrenic in-patients were divided into EPS high and low scorers according to an established criterion (Simpson Angus Scale, cut-off score: 0.4). Cognitive impairments were assessed using a self-rating instrument measuring disturbances of information processing. Patients with high EPS exhibited significantly elevated scores in six of ten cognitive and perceptual subscales (t = 2.1-3.1) as compared to low EPS patients. It is concluded that high EPS patients suffer from cognitive disturbances which are assumed to possess high relevance for both psycho-social and medical treatment. Cognitive problems may, when not considered, disturb compliance, insight of illness and transfer of learnt skills into everyday life. © 1999 Elsevier, Paris cognition / extrapyramidal symptoms / neuropsychology / side-effects Eur Psychiatry 1999 ; 14 : 84-8 © Elsevier, Paris
Current Topics in Neuroleptic-induced Extrapyramidal Symptoms in Japan
The Keio Journal of Medicine, 1996
This article reviews current topics in neuroleptic-induced extrapyramidal symptoms in Japan, focusing especially on the clinical features of akathisia and dystonia. Akathisia is a common side effect associated with antipsychotic drugs. It is most commonly characterized by subjective inner restlessness and objective motor signs, especially in the lower extremities. The mechanisms underlying akathisia remain unclear and controversial; however, an increase in the activity of (3-adrenergic systems relative to dopaminergic systems has been hypothesized, based on clinical therapeutic observations that p-blocking agents are effective in this condition. A Japanese version of the Barnes Akathisia Scale has recently been established and uses a standardized videotape method for its precise evaluation. Various acute and chronic manifestations of neuroleptic-induced dystonia have been reported in Japan, including blepharospasm, difficulty in opening the eye lids, torticollis, retrocollis, oculogyric crisis, and Pisa syndrome. This review also introduces several other topics related to drug-induced extrapyramidal symptoms in Japan. These include; 1) the Drug-Induced Extra-Pyramidal Symptoms Scale (DIEPSS), which has recently been established, 2) studies on the discontinuation of anticholinergic drugs, and 3) a summary of extrapyramidal symptoms induced by drugs other than neuroleptics.
Journal of Drug Delivery and Therapeutics
Psychosis is a mental disorder characterized by a disconnection from reality. Psychosis is a group of disorder characterized by thought disorder, abnormal behaviour, defective cognition, delusion and hallucination. Adverse drug reaction is defined as any undesired or unintended effects of drugs treatment. According to the World Health Organization (WHO)- “adverse drug reaction (ADRs) has been defined one which is noxious and unintended, and which occurs at doses normally used in man for prophylaxis, diagnosis, or therapy of disease, or modification of physiological function”. Adverse drug reactions are the most important causes of the mortality and morbidity. Antipsychotics are the most effective drugs which are used in the psychiatry in the maintenance therapy of mania, psychoses and schizophrenia. The antipsychotics drugs are chemically disparate but have the common property of alleviating the symptoms of organic as well as functional psychosis. But they also have a capacity to ca...