Extrapyramidal symptoms (EPS)
 Extrapyramidal
symptoms, often abbreviated EPS, is a neurological side effect of
antipsychotic medication. EPS can occur within the first few days
or weeks of treatment, or it can appear after months and years of
antipsychotic medication use.
EPS is more common among patients taking
conventional antipsychotic medications, compared to the newer atypical
drugs. More than 60% of the people who take conventional antipsychotic
medications experience some form of EPS.
EPS can cause a variety of symptoms, e.g.
involuntary movements, tremors and rigidity, body restlessness,
muscle contractions and changes in breathing and heart rate.
Involuntary movements (tardive dyskinesia)
One of the most common EPS side effects is involuntary movements
most often affecting the mouth, lips and tongue. For example, the
patient may have facial tics, roll the tongue and lick the lips.
Sometimes also the trunk or other parts of the body are also affected.
This side effect is usually managed or minimized
by reducing the medication dosage or by changing type of medication.
However, the symptoms may persist even through the medication is
altered.
Tremors and rigidity (Parkinsonism)
Some patients may develop symptoms resembling those affecting people
with Parkinsson´s disease. The symptoms include tremors, rigidity,
temporary paralysis and extreme slowness of movement. These symptoms
usually appears in the first few days and weeks of medication administration.
Sometimes the symptoms of medication induced
parkinsonism may be confused with the negative symptoms caused by
the schizophrenic disease itself. It is important to discuss the
symptoms with the responsible doctor, so he or she can take adequate
actions.
Body restlessness (akathisia)
Akathisia is a condition associated with the use of certain medications
and characterized by an internal sense of motor restlessness often
described as an inability to resist the urge to move. The most common
form of akathisia involves pacing and an inability to sit still.
This side effects is often very distressing to the patient, and
reduces the ability to perform every day tasks.
Muscle contractions (acute dystonia)
Acute dystonia is characterized by a spastic contraction of muscle
groups. It most often affects the neck, eyes and trunk. These involuntary
muscle contractions, that occur very suddenly, are often painful
to the patient.
In most cases, this side effect occurs within
the first couple of days of treatment. It can be effectively and
rapidly treated with medication.
Changing in breathing and heart rate (neuroleptic
malignant syndrome)
This syndrome is potentially fatal if not treated. It includes diffuse
muscle rigidity, tremor, high fever, labile blood pressure, cognitive
dysfunction, and autonomic disturbances. This condition can be sudden
and often occurs early in the course of treatment, often within
the first week.
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