Detection, Prevention, and Management of Extrapyramidal Symptoms

Extrapyramidal symptoms (EPSs), such as akathisia, dystonia, psuedoparkinsonism, and dyskinesia, are drug-induced side effects that can be problematic for persons who receive antipsychotic medications (APMs) or other dopamine-blocking agents. The clinical manifestations include a number of atypical involuntary muscle contractions that influence gait, movement, and posture. The symptoms can develop acutely, be delayed, or overlap making diagnosing a challenge. Preventive interventions include selective prescribing of APMs, close monitoring of uncharacteristic movements through the use of screening instruments, prompt management of symptoms, and thorough client education. Nurse practitioners who do not practice in psychiatric mental health nursing on a regular basis or who infrequently prescribe psychotropic medications must be cautious with these potential life-threatening symptoms.