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Extrapyramidal symptoms (EPS) are symptoms that are archetypically associated with the extrapyramidal system of the brain's cerebral cortex. When such symptoms are caused by medications or other drugs, they are also known as extrapyramidal side effects (EPSE). The symptoms can be acute (short-term) or chronic (long-term).
The first symptoms of neuroleptic malignant syndrome are usually muscle cramps and tremors, fever, symptoms of autonomic nervous system instability such as unstable blood pressure, and sudden changes in mental status (agitation, delirium, or coma). Other possible symptoms include sweating, trouble swallowing, tremors, incontinence, and mutism.
Oculogyric crisis (OGC) is a rare sudden, paroxysmal, dystonic reaction that may manifest in response to specific drugs, particularly neuroleptics, or medical conditions, such as movement disorders.
Other extrapyramidal movement disorders G25 Essential tremor: 333.1 G25.0 Drug induced tremor G25.1 Other specified form of tremor G25.2 Myoclonus: 333.2 G25.3 Chorea (rapid, involuntary movement) Drug induced chorea: G25.4 Drug-induced tics and tics of organic origin 333.3 G25.6 Paroxysmal nocturnal limb movement G25.80
Risperidone has a similar rate of extrapyramidal symptoms to haloperidol. [9] The American Psychiatric Association generally recommends that atypicals be used as first line treatment in most patients, but further states that therapy should be individually optimized for each patient. [14]
Diphenhydramine is a first-generation antihistamine used to treat several conditions including allergic symptoms and itchiness, the common cold, insomnia, motion sickness, and extrapyramidal symptoms. [19] [20] Diphenhydramine also has local anesthetic properties, and has been used as such in people allergic to common local anesthetics such as ...
Extrapyramidal symptoms (EPS) associated with typical antipsychotics: Early stage – occurs at onset of treatment or following increased dose, patients recover when dose is decreased [10] Acute dystonias [10] – muscle spasms and sustained abnormal postures and onset occurs within a few days; can be treated with anticholinergics
Biperiden is also commonly used to improve acute extrapyramidal side effects related to antipsychotic drug therapy, such as akathisia. It relieves muscle rigidity , reduces abnormal sweating related with clozapine and methadone use [ 9 ] [ 10 ] and salivation , improves abnormal gait , and to lesser extent, tremor .