Extrapyramidal Symptoms with Atypical Antipsychotics

@article{Pierre2005ExtrapyramidalSW,
  title={Extrapyramidal Symptoms with Atypical Antipsychotics},
  author={Joseph M. Pierre},
  journal={Drug Safety},
  year={2005},
  volume={28},
  pages={191-208}
}
The treatment of schizophrenia changed drastically with the discovery of antipsychotic medications in the 1950s, the release of clozapine in the US in 1989 and the subsequent development of the atypical or novel antipsychotics. These newer medications differ from their conventional counterparts, primarily based on their reduced risk of extrapyramidal symptoms (EPS). EPS can be categorised as acute (dystonia, akathisia and parkinsonism) and tardive (tardive dyskinesia and tardive dystonia… 

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References

SHOWING 1-10 OF 158 REFERENCES

Extrapyramidal symptoms and tolerability of olanzapine versus haloperidol in the acute treatment of schizophrenia.

The lower extrapyramidal symptom profile with olanzapine was evident despite statistically significantly more frequent use of anticholinergic drugs among haloperidol-treated patients, suggesting that olanZapine should contribute to better compliance with longer term maintenance treatment, with minimal anticholergic-associated events.

The treatment of tardive dyskinesia and tardive dystonia.

  • G. Simpson
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 2000
The enthusiasm produced by the introduction of antipsychotic medication in the 1950s gave way to a certain frustration in the 1970s and 1980s, and it is possible that schizophrenic patients taking atypical antipsychotics may experience fewer spontaneous dyskinesias, although further study is warranted.

Extrapyramidal signs and clinical symptoms in first-episode schizophrenia: response to low-dose risperidone.

Analysis of symptom response of the lower versus the higher doses of risperidone resulted in superior outcome in the 2- to 4-mg group for all three symptom clusters of the PANSS, which has clinical relevance directed at the early and longer-term treatment of schizophrenia.

Treatment of tardive dyskinesia.

Although the new generation of atypical antipsychotic agents could some day eliminate concerns about tardive dyskinesia, this disorder remains a significant clinical problem for patients and physicians and efforts to understand the neurobiology of TD may shed light on this persistent clinical conundrum.

The Risks and Benefits of Clozapine versus Chlorpromazine

It is suggested that clozapine is well tolerated and may be therapeutically superior to chlorpromazine in treating psychotic behavior and agranulocytosis potential can be minimized by frequent white blood cell counts and removing nonresponding patients from treatment prior to the peak risk period.

Frequency of Extrapyramidal Adverse Reactions in Schizophrenic Outpatients Treated with Risperidone, Olanzapine, Quetiapine or Haloperidol

The results suggest that the atypical antipsychotics studied are less likely to induce extrapyramidal adverse reactions compared with haloperidol in stabilised patients, although these reactions are still common.

Three cases of improvement of tardive dyskinesia following olanzapine treatment.

Olanzapine is a serotonin-dopamine-receptor antagonist, which has an affinity for neuroreceptors similar to that of clozapine, and Pooled tolerability data from controlled trials show that the overall incidence of TDk in patients treated with olanzAPine is significantly lower than in patients treating with haloperidol.

Atypical antipsychotics: are some more atypical than others?

Current clinical evidence is reviewed to compare current clinical evidence on four measures of atypicality: EPS, prolactin elevation, superior efficacy in refractory/positive symptoms and efficacy against negative symptoms.

Therapeutic strategies against tardive dyskinesia. Two decades of experience.

Although neuroleptics are significantly superior to most other methods of treatment in suppressing signs of dyskinesia, the safety of their long-term use in dyskinetic patients remains to be demonstrated.

Clozapine in tardive dyskinesia: observations from human and animal model studies.

The data suggest that dyskinetic patients lose their symptoms of tardive dyskinesia, along with dopaminergic hypersensitivity, with long-term clozapine treatment.
...