Treatment of acute neuroleptic-induced movement disorders

Pharmacotherapy. 1994 Sep-Oct;14(5):543-60.


Acute extrapyramidal syndromes (EPS), including dystonia, parkinsonism, and akathisia, are associated with the use of virtually all neuroleptic agents. They may be alleviated by reducing the neuroleptic dosage, switching to a lower-potency drug, or administering an adjunctive agent such as an anticholinergic, amantadine, benzodiazepine, or beta-blocker. Akathisia may be only partly dispelled by anticholinergics; alternatives are beta-blockers, benzodiazepines, and clonidine. In patients receiving long-term neuroleptic therapy, both the prophylactic use and the duration of treatment with concomitant anti-EPS drugs are controversial. Administration of prophylactic anti-EPS drugs should be based on the likelihood that the patient will develop EPS, as well as the risk of adverse reactions resulting from extended use of the agents in a specific patient. The decision to continue anti-EPS therapy should be reevaluated frequently, especially in elderly patients.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Acute Disease
  • Akathisia, Drug-Induced / drug therapy
  • Akathisia, Drug-Induced / etiology
  • Antipsychotic Agents / adverse effects*
  • Basal Ganglia Diseases / chemically induced*
  • Basal Ganglia Diseases / physiopathology
  • Cholinergic Antagonists / therapeutic use
  • Dopamine Agents / therapeutic use
  • Dystonia / chemically induced
  • Dystonia / drug therapy
  • Humans
  • Parkinson Disease, Secondary / chemically induced
  • Parkinson Disease, Secondary / drug therapy


  • Antipsychotic Agents
  • Cholinergic Antagonists
  • Dopamine Agents