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. Serotonin Syndrome
  8. Neuroleptic Malignant Syndrome (NMS)
  9. Lithium
  10. Lithium Toxicity
  11. Typical Antipsychotics
  12. Atypical Antipsychotics
  13. Trazodone
  14. Buspirone
  15. Mirtazapine
  16. CNS Stimulants
  17. Zolpidem
  18. Benzodiazepines
  19. Barbiturates
  20. Barbiturates (Old)
  21. Benzodiazepines (Old)
  22. Lithium (Old)
  23. Bupropion (Old)
  24. SNRIs (Old)
  25. MAOIs (Old)
  26. Amphetamines (Old)
  27. Typical Antipsychotics (Old)
  28. Atypical 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