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April 1973, Vol 28, No. 4 >
Article | April 1973

Neurological Syndromes Associated With Antipsychotic Drug Use: Title and subTitle BreakA Special Report

DANIEL X. FREEDMAN, MD
Arch Gen Psychiatry. 1973;28(4):463-467. doi:10.1001/archpsyc.1973.01750340009001
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Acute dystonias, akathisia, and parkinsonism have long been recognized as extrapyramidal side effects which occur in susceptible individuals who are taking neuroleptic (antipsychotic) drugs. These side effects often occur early in treatment and they usually respond to dosage reduction and/or the addition of corrective medication.

More recently a quite different syndrome, tardive dyskinesia has been found to be associated with antipsychotic drug use. Many aspects of the characteristics, etiology, prevention, and treatment of this variegated set of symptom complexes are very unclear at this time. However, patients who clearly show this syndrome are not uncommon and the condition sometimes persists with little improvement for periods of one to two years or indefinitely. The condition does not respond to antiparkinsonian medication. The Neuropharmacology Division of the Bureau of Drugs, the Food and Drug Administration (FDA), and the American College of Neuropsychopharmacology have recognized the seriousness of these complications and established a

REFERENCES

1 +
Akiskal HS, McKinney WT Jr:  Psychiatry and pseudopsychiatry . Arch Gen Psychiatry 28:367-373, 1973;.
2 +
Freyhan FA:  Psychomotility and parkinsonism in treatment with neuroleptic drugs . Arch Neurol Psychiatry 78:465-472, 1957;.
3 +
Freedman DX, DeJong J:  Factors that determine drug-induced akathisia . Dis Nerv Syst 22:1-8, 1961;.
4 +
Ayd FJ:  A survey of drug-induced extra pyramidal reactions . JAMA 175:1054-1060, 1961;.
5 +
Crane GE, Gardner R: Psychotropic Drugs and Dysfunctions of the Basal Ganglia. Government Printing Office, 1969.
6 +
Crane G, Naranjo E:  Motor disorder induced by neuroleptics . Arch Gen Psychiatry 24:179-184, 1971;.
7 +
Kazamatsuri H, Cole J:  Treatment of tardive dyskinesia: I . Arch Gen Psychiatry 27:95-99, 1972;.
8 +
Kazamatsuri H, Chien C, Cole J:  Treatment of tardive dyskinesia: II. Short-term efficacy of dopamine-blocking agents, haloperidol and thiopropazate . Arch Gen Psychiatry 27:100-105, 1972;.
9 +
Kazamatsuri H, Chien C, Cole J:  Therapeutic approaches to tardive dyskinesia: A review of the literature . Arch Gen Psychiatry 27:491-501, 1972;.
10 +
Paul G, Tobias L, Holly B:  Maintenance Psychotropic drugs in presence of active treatment programs . Arch Gen Psychiatry 27:106-118, 1972;.
11 +
Klein D, Davis J: Diagnosis and Drug Treatment . Baltimore, Williams & Wilkins, 1969;.
12 +
May PRA: Treatment of Schizophrenia: A Comparative Study of Five Treatment Methods . New York, Science House, 1968;.
13 +
Hogarty GE, Goldberg SC:  Drugs and sociotherapy in the aftercare of schizophrenic patients . Arch Gen Psychiatry 28:54-64, 1973;.
14 +
Rubovitz R, Klawans H:  Implication of amphetamine-induced stereotyped behavior as a model of tardive dyskinesias . Arch Gen Psychiatry 27:502-510, 1972;.
15 +
Kazamatsuri H, Chien C, Cole J:  Treatment of tardive dyskinesia: III. Clinical efficacy of a dopamine competing agent, methyldopa . Arch Gen Psychiatry 27:824-827, 1972;.
16 +
Lipper S:  Impairment of optokinetic nystagmus in patients with tardive dyskinesia . Arch Gen Psychiatry 28:331-338, 1973;.

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1 +
Akiskal HS, McKinney WT Jr:  Psychiatry and pseudopsychiatry . Arch Gen Psychiatry 28:367-373, 1973;.
2 +
Freyhan FA:  Psychomotility and parkinsonism in treatment with neuroleptic drugs . Arch Neurol Psychiatry 78:465-472, 1957;.
3 +
Freedman DX, DeJong J:  Factors that determine drug-induced akathisia . Dis Nerv Syst 22:1-8, 1961;.
4 +
Ayd FJ:  A survey of drug-induced extra pyramidal reactions . JAMA 175:1054-1060, 1961;.
5 +
Crane GE, Gardner R: Psychotropic Drugs and Dysfunctions of the Basal Ganglia. Government Printing Office, 1969.
6 +
Crane G, Naranjo E:  Motor disorder induced by neuroleptics . Arch Gen Psychiatry 24:179-184, 1971;.
7 +
Kazamatsuri H, Cole J:  Treatment of tardive dyskinesia: I . Arch Gen Psychiatry 27:95-99, 1972;.
8 +
Kazamatsuri H, Chien C, Cole J:  Treatment of tardive dyskinesia: II. Short-term efficacy of dopamine-blocking agents, haloperidol and thiopropazate . Arch Gen Psychiatry 27:100-105, 1972;.
9 +
Kazamatsuri H, Chien C, Cole J:  Therapeutic approaches to tardive dyskinesia: A review of the literature . Arch Gen Psychiatry 27:491-501, 1972;.
10 +
Paul G, Tobias L, Holly B:  Maintenance Psychotropic drugs in presence of active treatment programs . Arch Gen Psychiatry 27:106-118, 1972;.
11 +
Klein D, Davis J: Diagnosis and Drug Treatment . Baltimore, Williams & Wilkins, 1969;.
12 +
May PRA: Treatment of Schizophrenia: A Comparative Study of Five Treatment Methods . New York, Science House, 1968;.
13 +
Hogarty GE, Goldberg SC:  Drugs and sociotherapy in the aftercare of schizophrenic patients . Arch Gen Psychiatry 28:54-64, 1973;.
14 +
Rubovitz R, Klawans H:  Implication of amphetamine-induced stereotyped behavior as a model of tardive dyskinesias . Arch Gen Psychiatry 27:502-510, 1972;.
15 +
Kazamatsuri H, Chien C, Cole J:  Treatment of tardive dyskinesia: III. Clinical efficacy of a dopamine competing agent, methyldopa . Arch Gen Psychiatry 27:824-827, 1972;.
16 +
Lipper S:  Impairment of optokinetic nystagmus in patients with tardive dyskinesia . Arch Gen Psychiatry 28:331-338, 1973;.

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