Medicine & USMLE

Extrapyramidal Symptoms (EPS)

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Mental Health Drugs
  1. Bupropion
  2. SNRIs
  3. SSRIs
  4. MAOIs
  5. Tricyclic Antidepressants (TCAs)
  6. Extrapyramidal Symptoms (EPS)
  7. Lithium
  8. Typical Antipsychotics
  9. Atypical Antipsychotics
  10. Trazodone
  11. Buspirone
  12. Mirtazapine
  13. CNS Stimulants
  14. Zolpidem
  15. Benzodiazepines
  16. Barbiturates
  17. Neuroleptic Malignant Syndrome (NMS)
  18. Barbiturates (Old)
  19. Benzodiazepines (Old)
  20. Lithium (Old)
  21. Bupropion (Old)
  22. SNRIs (Old)
  23. MAOIs (Old)
  24. Amphetamines (Old)
  25. Typical Antipsychotics (Old)

Summary

Extrapyramidal symptoms, abbreviated EPS, are most commonly caused as a side effect of antipsychotics and antiemetics.

They are a group of movement disorders that include acute dystonia, parkinsonism, akathisia, and tardive dyskinesia.

The anticholinergic medication benztropine is a common treatment for EPS.

Key Points

  • Extrapyramidal Symptoms (EPS)
    • Manifestations
      • Acute Dystonia
        • Involuntary eye movement
        • Muscle spasms
          • Tongue, neck, face, and back
      • Parkinsonism
        • Tremors
        • Muscle rigidity
        • Shuffling gait
      • Akathisia
        • Restlessness
      • Tardive Dyskinesia (TD)
        • Involuntary face and tongue movement
          • Tongue protrusion/rolling
          • Lip smacking
        • A late extrapyramidal symptom that occurs months to years after starting treatment
    • Causes
      • Antipsychotics
        • Typical antipsychotics are the most common cause of EPS
      • Antiemetics
        • Including ondansetron and metoclopramide
    • Treatment
      • Benztropine
        • An anticholinergic medication