Adverse Psychotropic Medication Reactions: Movement Disorders (01:48)
Extrapyramidal side effects (EPS), are of concern in patients receiving psychotropic medications. They are more prevalent in first generation anti-psychotics, and can become chronic if ignored.
Tardive Dyskinesia and Dystonia (02:18)
Tardive dyskinesia involves abnormal facial movements and finger curling. Bradykinesia is abnormally slow movement; absence of movement is akinesia. Dystonia involves painful neck and back spasms. Diphenhydramine and benzodiazepines can relieve symptoms.
Oculogyric Crisis (00:40)
Oculogyric crisis is an adverse drug reaction to psychotropic medications. It is characterized by the eyes becoming fixed in a single direction, usually upward. It should be considered an emergency situation.
Akathisia occurs most often in women, and manifests as strong feelings of restlessness preventing the patient from sitting still.
The elderly, women, and dehydrated patients are most susceptible. They may have slurred speech, stiff posture, and coarse motor tremors. Seborrheic dermatitis occurs in nearly all cases.
Paroxysms are the rarest form of movement disorders, and are manifested in body spasms or pseudo seizures. They can be painful and result in injury.
Neuroleptic Malignant Syndrome (NMS) (02:50)
The rare yet life threatening reaction is associated with drugs decreasing dopamine receptor activity. It includes hyperthermia, muscle rigidity, tremors, and autonomic instability. Lab results include elevated CPK and electrolytes, decreased serum iron, and dehydration; treatment includes IV fluids, antipyretics, and benzodiazepines.
Assessment and Evaluation (04:22)
Movement disorders can be intensified by anxiety; distinguishing psychiatric symptoms from side effects can be challenging. Learn about the Abnormal Involuntary Movement Scale (AIMS), modified Simpson Angus Scale (SAS), and Barnes Akathisia Scale (BARS).
Credits: Movement Disorders (00:59)
Credits: Movement Disorders
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