Neuroleptic-induced movement disorders: an overview.
نویسنده
چکیده
Movement disorders commonly are associated with many psychotropic drugs. Tricyclic antidepressants often cause a tremor in the hands and myoclonic jerks. In some patients, they result in agitation and restlessness, referred to as the jitteriness syndrome [1]. Occasional anecdotes of dyskinesia and dystonia have been reported with these drugs, but tardive dyskinesia typically is not associated with tricyclics, with the possible exception of amoxapine [2]. Movement disorders are reported somewhat more commonly with serotonin-specific reuptake inhibitors (SSRIs), including mild parkinsonian symptoms, dystonia, dyskinesia, and akathisia. There have been some reports of irreversible dyskinesia and dystonia with these drugs [3]. Lithium most commonly is associated with a peripheral tremor, which is usually a mild action tremor, but becomes coarse when toxic levels are reached. Lithium produces myoclonus less often, and is also known to exacerbate the parkinsonian adverse effects of neuroleptics. Stimulants are associated with stereotypes, dyskinesia, tremor, dystonia, and myoclonus. Anticonvulsants (eg, phenytoin or carbamazepine) are associated with dyskinesia, tremor, and tics, and in toxic doses will produce nystagmus, ataxia, and dysarthria. Anticholinergic drugs can exacerbate dyskinesias. Of course there many other drugs used in medicine that may cause disorders of movement, and the reader is referred to some recent publications on this topic [4–6]. The overwhelming concern of psychiatrists is with neuroleptic-induced movement disorders (NIMD). These may be categorized on the basis of the temporal relationship to neuroleptic use (acute and delayed or tardive) or their characteristics (hyperkinetic or hypokinetic, sometimes referred to as positive or negative). Acute NIMDs include acute dystonia, akathisia,
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ورودعنوان ژورنال:
- The Psychiatric clinics of North America
دوره 28 1 شماره
صفحات -
تاریخ انتشار 2005