II. Causes: Antipsychotics

  1. Haloperidol (Haldol) or Haloperidol decanoate
  2. Perphenazine (Trilafon)
  3. Thiothixene HCl (Navane)
  4. Fluphenazine HCl (Prolixin)
  5. Trifluoperazine (Stelazine)
  6. Risperidone (Risperdal)

III. Adverse Effects: Reversible Extrapyramidal signs and symptoms

  1. Conditions responsive to anti-Parkinsons Agents
    1. Akinesia (lack of movement, Parkinson-like)
    2. Dystonic Reaction (facial muscle spasm, neck, back)
    3. Dyskinesia (Blinking or twitches)
    4. Akathisia (Can not to sit still, inner restlessness)
    5. Perioral Tremor (Rabbit Syndrome)
  2. Neuroleptic Malignant Syndrome
    1. Presents as Catatonia, fever, unstable Blood Pressure
    2. Life-threatening; Stop Antipsychotic immediately

IV. Adverse Effects: Irreversible

  1. Evaluate for these signs monthly while on Antipsychotic
  2. Tardive Dyskinesia
    1. Hyperkinesia (lingual or facial)
      1. Blinking
      2. Lip smacking
      3. Sucking or chewing
      4. Rolls or protrudes Tongue
      5. Grimaces
    2. Choreoathetoid extremity movement
      1. Clonic jerking fingers, ankles, toes
    3. Tonic contractions of neck or back

V. Management

  1. Reversible Extrapyramidal Effects
    1. Tolerance to affect
    2. Decrease or Increase OR Discontinue drug dose
    3. Shift patient to a non-EPSE side effect
    4. Antihistamine (Benadryl)
  2. Tardive Dyskinesia
    1. Consider Clozapine as alternative Antipsychotic

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Ontology: Dyskinetic syndrome (C0013384)

Definition (CHV) a disease characterized by abnormal involuntary movements of muscles
Definition (NCI_FDA) Difficulty moving; distortion or impairment of voluntary movement, as in tic, spasm, or myoclonus.
Definition (NCI) Difficulty moving; distortion or impairment of voluntary movement, as in tic, spasm, or myoclonus.
Definition (MSH) Abnormal involuntary movements which primarily affect the extremities, trunk, or jaw that occur as a manifestation of an underlying disease process. Conditions which feature recurrent or persistent episodes of dyskinesia as a primary manifestation of disease may be referred to as dyskinesia syndromes (see MOVEMENT DISORDERS). Dyskinesias are also a relatively common manifestation of BASAL GANGLIA DISEASES.
Definition (PSY) Abnormal involuntary motor processes that occur due to underlying disease processes.
Concepts Disease or Syndrome (T047)
MSH D020820
ICD10 G24 , G24.9
SnomedCT 206824003, 9748009, 229694001
English Dyskinesias, DYSKINETIC SYNDROME, [D]Dyskinesia, Dyscinesia, Dyskinesis, Dyskinetic syndrome, Syndrome dyskinetic, Abnormal Movement, Abnormal Movements, Movement, Abnormal, Movements, Abnormal, Dyskinesia NOS, Dyskinesias [Disease/Finding], dyskinesia, DYSKINESIA, Dyskinesia, Dyskinesia (finding), Dyskinesia (finding) #09
French DYSKINESIE, Syndrome dyskinétique, Mouvement anormal, Mouvements anormaux, Dyscinésies, SYNDROME DE DYSKINESIE, Dyskinésie, Dyskinésies
Spanish DISCINESIA, Síndrome discinético, DISCINETICO, SINDROME, Disquinesias, discinesia (hallazgo), discinesia, Discinesia, Discinesias
Italian Discinesia, Sindrome discinetica, Movimenti anormali, Discinesie
Dutch dyskinetisch syndroom, syndroom dyskinetisch, dyskinesie, Dyskinesie
German Dyskinetisches Syndrom, Syndrom dyskinetisch, DYSKINESIE, DYSKINETISCHES SYNDROM, Dyskinesie, Dyskinesien
Portuguese Síndrome disquinética, DISQUINESIA, SINDROME DE DISQUINESIA, Discinesia, Discinesias
Swedish Dyskinesi
Czech dyskinézy, Dyskineze, Dyskinetický syndrom
Finnish Dyskinesiat
Russian DVIZHENIIA NEPROIZVOL'NYE, TREMOR DISKINETICHESKII, DISKINEZII, ДВИЖЕНИЯ НЕПРОИЗВОЛЬНЫЕ, ДИСКИНЕЗИИ, ТРЕМОР ДИСКИНЕТИЧЕСКИЙ
Japanese 強制運動, 羽ばたき振戦, 半側バリスム, 片側バリスム, ジスキネジー, バリスムス, 羽ばたき振せん, 固定姿勢不能症, バリスム, 振戦-羽ばたき, 片側バリズム, 異常運動症, 固定姿勢不能, ルイス体症候群, 異常運動, ジスキネジア, ジスキネジア症候群, ジスキネジア, ジスキネジアショウコウグン
Croatian Not Translated[Dyskinesias]
Polish Zaburzenia ruchów dowolnych, Ruchy mimowolne, Dyskinezy
Hungarian Dyskinesia, Dyskinetikus syndroma, Dyskinetikus tünetegyüttes
Norwegian Dyskinesier, Dyskinesi

Ontology: Dyskinesia, Drug-Induced (C0013386)

Definition (MSH) Abnormal movements, including HYPERKINESIS; HYPOKINESIA; TREMOR; and DYSTONIA, associated with the use of certain medications or drugs. Muscles of the face, trunk, neck, and extremities are most commonly affected. Tardive dyskinesia refers to abnormal hyperkinetic movements of the muscles of the face, tongue, and neck associated with the use of neuroleptic agents (see ANTIPSYCHOTIC AGENTS). (Adams et al., Principles of Neurology, 6th ed, p1199)
Concepts Disease or Syndrome (T047)
MSH D004409
SnomedCT 102448004, 38941006
English Drug-Induced Dyskinesia, Drug-Induced Dyskinesias, Dyskinesia, Drug Induced, Dyskinesia, Drug-Induced, Dyskinesias, Drug-Induced, DYSKINESIA DRUG IND, Dyskinesia, Drug-Induced [Disease/Finding], drug dyskinesias induced, Drug-induced dyskinesia, Drug-induced dyskinesia (disorder)
Swedish Dyskinesi, läkemedelsframkallad
Czech dyskinéze léková
Portuguese Discinesia Induzida por Medicamentos, Discinesia Induzida por Drogas
Spanish Discinesia Inducida por Medicamentos, Discinesia Inducida por Drogas, discinesia medicamentosa (trastorno), discinesia medicamentosa
Finnish Lääkkeen aiheuttama dyskinesia
Russian DISKINEZIIA LEKARSTVENNAIA, ДИСКИНЕЗИЯ ЛЕКАРСТВЕННАЯ
Japanese 運動異常症-薬物誘発性, ジスキネジア-遅発性, 薬物性運動異常症, 薬物性ジスキネジー, 運動障害-薬物誘発性, ジスキネジー-薬物性, 薬物誘発性ジスキネジア, 遅発性ジスキネジア, 薬物誘発性運動異常症, 晩発性運動異常症, 薬剤誘発性運動異常症, 運動異常症-薬物性, 運動異常症-晩発性, ジスキネジア-薬物誘発性
Polish Dyskineza polekowa
Norwegian Dyskinesi, legemiddelutløst, Legemiddelutløst dyskinesi
German Dyskinesia tarda, Dyskinesie, arzneimittelinduzierte, Dyskinesie, tardive, Tardive Dyskinesie
Italian Discinesia indotta da farmaci
Dutch Dyskinesie, geneesmiddelgeïnduceerde, Geneesmiddelgeïnduceerde dyskinesie
French Dyskinésie due aux médicaments, Dyskinésie induite par les médicaments

Ontology: Akinesia (C0085623)

Concepts Disease or Syndrome (T047)
SnomedCT 33994004
English AKINESIA, akinesias, akinesia, Akinesia, Akinesia (finding)
Italian Acinesia
Portuguese ACINESIA, Acinesia
Spanish ACINESIA, acinesia (hallazgo), acinesia, aquinesia, Acinesia
German AKINESE, Akinesie
French AKINESIE, Akinésie
Czech Akineze
Japanese 無動, ムドウ
Hungarian Akinesia
Dutch akinesie

Ontology: Dystonic reaction (C0541919)

Concepts Finding (T033)
Dutch dystonische reactie
French Réaction dystonique
German dystonische Reaktion
Italian Reazione distonica
Portuguese Reacção distónica
Spanish Reacción distónica
Czech Dystonická reakce
English Dystonic reaction, dystonic reaction, dystonic reactions
Hungarian Dystoniás reakció
Japanese ジストニア反応, ジストニアハンノウ

Ontology: Tardive Dyskinesia (C0686347)

Definition (CSP) iatrogenic extrapyramidal disorder produced by long-term administration of antipsychotic drugs; characterized by oral/lingual/buccal dyskinesias and choreoathetoid movements of the extremities.
Concepts Disease or Syndrome (T047)
ICD10 G24.01
SnomedCT 123304005, 267689009, 155007009, 192861006, 38941006
English Tardive dyskinesia, DYSKINESIA TARDIVE, Tardive Dyskinesia, TARDIVE DYSKINESIA, tardive dyskinesia (diagnosis), tardive dyskinesia, Dyskinesia tardive, dyskinesia tardive, dyskinesias tardive, Tardive dyskinesia (disorder), Tardive dyskinesia -RETIRED-
Portuguese DISCINESIA TARDIA, Disquinésia tardia, Discinesia tardia
Spanish DISCINESIA TARDIA, discinesia oral tardía - RETIRADO -, discinesia oral tardía - RETIRADO - (concepto no activo), Discinesia tardía
Italian Discinesia tardiva
Dutch dyskinesie tardief, tardieve dyskinesie
German Dyskinesie tardiv, DYSKINESIE TARDIV, tardive Dyskinesie
French DYSKINESIE TARDIVE, Dyskinésie tardive
Czech Tardivní dyskineze
Hungarian Tardiv dyskinesia
Japanese 遅発性ジスキネジア, チハツセイジスキネジア