Extrapyramidal symptoms are movement disorders associated with antipsychotic drugs and other disorders involving dopamine. Symptoms include muscle twitching, difficulty sitting still, and involuntary muscle movements, and can become life-threatening. Changing medication or dosage and prescribing medication to manage symptoms are treatment options.
Extrapyramidal symptoms are movement disorders associated with malfunctions in a part of the brain known as the extrapyramidal system, which is responsible for coordinating physical movement. Patients and healthcare professionals should be alert to early warning signs of these symptoms as they can become life threatening. Often the first extrapyramidal symptoms manifest themselves in the form of muscle twitching, difficulty sitting still, and involuntary muscle movements. They are usually associated with antipsychotic drugs such as haloperidol and amoxapine, but can also sometimes appear in patients with Parkinson’s disease and other disorders involving dopamine.
Some patients may develop extrapyramidal symptoms as soon as they start an antipsychotic drug and they can become very severe within a short period of time. Other patients may use medications for weeks, months, or years before symptoms begin to develop. The irregular onset means that patients should always remain vigilant for the warning signs of neurological problems, as they can appear at any time. Healthcare professionals in mental health settings are also alert to early symptoms.
A group of extrapyramidal symptoms known as dyskinesias involve movement disorders in which the patient may make twitching or rolling movements. She cannot control her movements and is usually unable to sit still. This can make it difficult to complete tasks. A shuffling, twisting gait may develop, and some patients have difficulty with balance. They may also develop facial tics or twitches which can be highly distracting and may even make communication difficult. Verbal tics such as repetition or difficulty forming certain words can also become a problem.
Dystonias are another example of extrapyramidal symptoms. These pertain to involuntary and abnormal muscle tension that forces patients into uncomfortable and sometimes painful twisted or bent positions. The patient’s head may be tilted at an odd angle, for example, or the patient may bend over and have trouble straightening up afterward. This can be extremely painful and can cause distress as the patient will have trouble with daily activities.
One option for managing extrapyramidal symptoms is to change the patient’s medication or dosage. Some of these symptoms may be permanent and it is important to prevent progressive damage. If a medication doesn’t work for a patient, a change in treatment can manage the underlying mental health condition without side effects. A doctor may also prescribe medications to directly manage symptoms. Patients with Parkinson’s, for example, can take a drug known as l-dopa to normalize dopamine levels and control movement disorders.
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