Topics tagged with "Schizophrenia and movement disorders"

Extrapyramidal

What are extrapyramidal side effects? Extrapyramidal side effects include dyskinesias; repetitive, involuntary, and purposeless body or facial movements. Parkinsonism may occur, involving cogwheel muscle rigidity, pill-rolling tremor and reduced or slowed movements. Akathisia involves motor restlessness, especially in the legs, and dystonias are muscle contractions causing unusual twisting of parts of the body, most often in the neck. These side effects are caused by the dopamine receptor antagonist action of antipsychotics. What is the evidence for extrapyramidal side effects? All antipsychotics versus placebo Moderate quality evidence shows a small effect of fewer extrapyramidal side effects with clozapine than placebo. Small…

GABA agonists

What are GABA-acting medications? GABA (gamma-aminobutyric acid) is a common neurotransmitter in the brain, and GABA-ergic neurons are thought to interact with antipsychotic medications, contributing to side effects such as tardive dyskinesia. GABA-acting medications, such as baclofen, progabide, or sodium valproate, may contribute to increasing the activity of GABA neurons, potentially leading to reduced medication side effects. Adjunct medications prescribed to treat side effects of antipsychotic medication may contribute to increasing adherence to these medications, and reduce the risk of psychotic relapse. What is the evidence for GABA-acting medications? Moderate quality evidence suggests a small benefit of GABA-acting agents for…

Beta blockers

What are beta blockers?  Beta blockers can be prescribed in addition to standard antipsychotic regimes in order to target some side effects of these medications, including extrapyramidal symptoms such as akathisia (a type of restlessness, a common and early-onset side effect of many neuroleptics). Beta blockers are adrenergic beta receptor antagonists, inhibiting the action of neurotransmitters adrenaline/epinephrine and noradrenaline/norepinephrine on beta-receptors, ultimately influencing brain regions that control functions such as movement. Beta blockers have also been used to reduce the physical symptoms of anxiety in people with schizophrenia (for example, pounding heart, clammy hands, sweating), and have also been suggested…

Cholinergic medications

What are cholinergic medications? Cholinergic medications have been prescribed for tardive dyskinesia, which is a common side effect of antipsychotics, involving repetitive, involuntary movements most commonly occurring around the mouth and face. The cause of tardive dyskinesia is largely unknown, however some theories proposing the cause implicates brain cells that utilise the acetylcholine neurotransmitter. Older cholinergic medications (such as those included in this summary) can have adverse effects themselves, while newer compounds have less severe side effects, but they have not yet been studied in relation to tardive dyskinesia. What is the evidence on cholinergic medications? Moderate to high quality…

Anticholinergic medications

How are anticholinergic medications used for schizophrenia? Anticholinergics block the action of the neurotransmitter acetylcholine. Anticholinergic medications may have some utility for the treatment of side effects of antipsychotic medications, including movement disorders like akathisia (a type of restlessness, a common side effect of many neuroleptics), as well as excessive salivation. Adjunct medications prescribed to treat such side effects may contribute to increasing adherence to antipsychotic medications, and reduce the risk of psychotic relapse. What is the evidence for anticholinergic medications? Moderate quality evidence suggests small to medium-sized effects of greater improvement in hypersalivation with astemizole or propantheline over placebo,…

Treatments for movement disorders

What are movement disorders? Movement disorders such as extrapyramidal symptoms are common side effects of many antipsychotic medications. Extrapyramidal symptoms include tardive dyskinesia, a severe and chronic condition involving repetitive, involuntary movements, most commonly occurring around the mouth and face. Akathisia is characterised by a feeling of restlessness and movements such as shuffling of the legs, pacing, rocking from foot to foot, or the inability to sit down or stand still. Dystonia involves muscular spasms and abnormal postures. Medications prescribed to treat the side effects of antipsychotic drugs increase adherence to antipsychotics, which reduces the risk of psychotic relapse. What…

Movement disorders

What are movement disorders?  Movement disorders have been reported in people with schizophrenia, with tardive dyskinesia among the most commonly reported. This disorder is a ‘hyper-kinetic’ (excessive movement) disorder, characterised by jerky, involuntary movements, usually of the face and/or limbs. Parkinsonism is another movement disorder associated with schizophrenia, and is a ‘hypo-kinetic’ (reduced movement) disorder, characterised by slowness of movement and rigidity. Movement disorders are primarily associated with the use of antipsychotic medications, however they have also been reported in people who are antipsychotic-naïve. What is the evidence for movement disorders in schizophrenia? Moderate to high quality evidence suggests a…

Psychomotor ability

What is psychomotor ability? Psychomotor ability refers to a wide range of actions involving physical movement related to conscious cognitive processing. Psychomotor ability may be measured by accuracy or speed (reaction time). Examples of psychomotor tests include the Grooved Pegboard test, and the Purdue Pegboard test that measure visual-motor coordination. The Finger Tapping test requires study participants to place their dominant hand face-down and tap as quickly as possible. The task is repeated with the non-dominant hand and assesses motor speed, manual dexterity and lateralisation. The Digit Symbol Substitution test involves paired numbers and symbols. Participants are shown several numbers…

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