Tardive Dyskinesia and Other Neuroleptic-Induced Syndromes
Adverse effects of drugs blocking D2 dopamine receptors (Table 117.1), especially antipsychotic agents (phenothiazines, butyrophenones); metoclopramide, flunarizine, cinnarizine.
Likelihood of these adverse effects for atypical neuroleptics: zero for clozapine (except acute akathisia); near zero for quetiapine; low but definite for olanzapine; unknown for newer agents.
Dopamine-depleting drugs (reserpine, tetrabenazine): acute akathisia, drug-induced parkinsonism.
Acute dystonic reaction: twisting postures of limbs, trunk, neck, tongue, face. Mostly in first few days; children, young adults, males. Easily reversed by parenteral antihistamines, anticholinergic drugs, diazepam.
Acute akathisia: defined in Chapter 9. Propranolol may help; disappears on discontinuing offending drug.Related posts:
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