Extrapyramidal symptoms

Many people with mental illnesses need to take oral medications every day to suppress or control their condition. Extrapyramidal symptoms also refer to multiple aspects, such as acute muscle strength disorders, which is manifested by involuntary eye rolling, etc.; Parkinson's disease is one of them, and in severe cases, the patient will lose the ability to move; there is also tardive dyskinesia, an early-stage disease characterized by slight tremors of the tongue. All mental illnesses should be controlled with medication on time and in the right dosage.

1. Extrapyramidal symptoms

Extrapyramidal reactions (EPS) are the most common adverse reactions of the nervous system to traditional antipsychotics, mainly including 4 types:

1. Acute dystonia: appears first. Continuous tonic contraction of local muscle groups presents involuntary and strange manifestations, such as eyes rolling up, torticollis, backward neck, facial distortion, etc.

2. Akathisia: occurs after 1 to 2 weeks of treatment. Walking back and forth, feeling anxious or unhappy, uncontrollable agitation, inability to sit still, pacing back and forth, marching in place, etc.

3. Parkinson's disease: appears 1 to 2 months after treatment. Akinesia, hypertonia, tremor, autonomic dysfunction. Initially, the movement was bradykinesia and the handwriting became smaller and smaller. In severe cases, there is loss of coordinated movement, stiffness, hunched posture, panic gait, mask-like face, coarse tremor, drooling, and seborrhea.

4. Tardive dyskinesia: It is more common after several years of continuous use. Characterized by involuntary, rhythmic, stereotyped movements. The severity fluctuates, disappearing during sleep and increasing during emotional excitement. It may begin as a slight tremor around the tongue or lips.

2. Drugs that cause extrapyramidal reactions

1. Antipsychotics

Chlorpromazine, trifluoperazine, fluphenazine, haloperidol, perphenazine, lithium carbonate, tricyclic antidepressants, etc. Generally speaking, the incidence of extrapyramidal reactions caused by this type of drugs is the highest and is related to the drug dose, course of treatment and individual.

2. Metoclopramide

It is related to the dosage and duration of medication. If the dosage is controlled below 30 mg per day and used for a short period of time, the incidence can be significantly reduced.

3. Cardiovascular drugs

It has been reported that nifedipine, cinnarizine, flunarizine, levodopa, and reserpine (in large doses) can all cause extrapyramidal reactions.

4. Others

Domperidone, cimetidine, carbamazepine, pentoxyverine (Kebiqing), ethambutol, etc. may also occasionally cause extrapyramidal reactions.