Extrapyramidal symptoms are a reaction of the organism that arises when an area of the brain responsible for coordinating movements, called the Extrapyramidal System, is affected. This can happen either due to side effects of medicines, such as Metoclopramide, Quetiapine or Risperidone, for example, or certain neurological diseases, which include Parkinson's disease, Huntington's disease or stroke sequelae.
Involuntary movements such as tremors, muscular contractures, difficulty walking, slowing of movements or restlessness are some of the main extrapyramidal symptoms, and when associated with medications, they may appear soon after use or may appear slowly, due to their continued use for years or months.
When it arises due to the sign of a neurological disease, extrapyramidal movements tend to worsen gradually over the years, as the disease worsens. Also check out what are the conditions and diseases that cause tremor in the body.
How to identify
The most frequent extrapyramidal symptoms include:
- Difficulty keeping calm; Feeling restless, moving your feet a lot, for example; Changes in movement, such as tremors, involuntary movements (dyskinesia), muscle spasms (dystonia) or restlessness, such as moving your legs frequently or not being able to stand still (akathisia); slowed movements or sluggish walking; altered sleep patterns; difficulty in concentration; changes in voice; difficulty in swallowing; involuntary movements of the face.
These symptoms can often be mistaken as signs of other psychiatric problems such as anxiety, panic attacks, Tourette 's syndrome or even stroke symptoms.
What are the causes
Extrapyramidal symptoms can appear as a side effect of medications, right after the first dose or appear as a result of continuous use, taking between a few weeks to months to start and, therefore, when they appear it is advisable to consult the doctor who prescribed the medication to evaluate the need to reduce the dose or make adjustments in treatment. Furthermore, although they can happen to anyone, they are more frequent in women and elderly patients.
These symptoms can also be a consequence of a neurological disease, with Parkinson's disease being the main representative. Find out what causes Parkinson's disease, how to identify and treat it.
Other neurological diseases include degenerative diseases such as Huntington's disease, Lewy body dementia, stroke sequelae or encephalitis, and dystonia or myoclonus, for example.
List of drugs that can cause
Some of the drugs that most often cause extrapyramidal symptoms to appear are:
| Drug class | Examples |
| Antipsychotics | Haloperidol (Haldol), Chlorpromazine, Risperidone, Quetiapine, Clozapine, Olanzapine, Aripripazole; |
| Antiemetics | Metoclopramide (Plasil), Bromopride, Ondansetron; |
| Antidepressants | Fluoxetine, Sertraline, Paroxetine, Fluvoxamine, Citalopram, Escitalopram; |
| Anti-vertigo | Cinnarizine, Flunarizine. |
What to do when they arise
When an extrapyramidal symptom appears, it is very important to consult, as soon as possible, the doctor who prescribed the medication that may be causing it to appear. It is not recommended to stop taking or change the medication without medical advice.
The doctor may recommend adjustments in treatment or may change the medication used, however, each case needs to be evaluated individually. In addition, throughout the treatment with this type of medication, frequent reevaluations are necessary, so it is important to go to all revision consultations, even when there are no side effects. Check out the reasons for not taking medication without the doctor's guidance.
