Neurological complications of psychiatric drugs: clinical features and management

摘要: This paper reviews the main neurological complications of psychiatric drugs, in particular antipsychotics and antidepressants. Extrapyramidal syndromes include acute dystonia, parkinsonism, akathisia, tardive dyskinesia dystonia. symptoms (EPS) are less frequent with atypical than conventional but remain common clinical practice partly due to lack screening by health professionals. Neuroleptic malignant syndrome (NMS) consists severe muscle rigidity, pyrexia, change conscious level autonomic disturbance partial forms also occur. NMS is particularly associated initiation rapid increase dose high-potency it has been reported all rarely other drugs including Serotonin toxicity comprises altered mental state (agitation, excitement, confusion), neuromuscular hyperactivity (tremor, clonus, myoclonus, hyper-reflexia) occurs on a spectrum. Severe cases, termed serotonin syndrome, usually follow co-prescription that serotonergic transmission different pathways, for example monoamine oxidase inhibitor (MAOI) selective reuptake (SSRI). Most antidepressants lower seizure threshold can cause seizures; risk greater clozapine tricyclic (TCAs) SSRIs. In randomised controlled trials elderly patients dementia higher stroke death placebo. Cohort studies suggest carry at least same risk. Cessation treatment lead wide range discontinuation which movement disorders symptoms. Clinicians need be familiar strategies reduce these adverse events manage them when they arise. Their occurrence needs balanced against benefits terms efficacy improved quality life disorders. Copyright © 2007 John Wiley & Sons, Ltd.