Extrapyramidal collateral effects induced by neuroleptic agents. II. Acute extrapyramidal effects

Beside tardive dyskinesia, that was discussed in the first part of the review, published in 'Psicosi' vol. 3, 1994, also acute extrapyramidal side effects have an important role in the management of antipsychotic therapy. Acute extrapyramidal side effects incidence is quite higher than that of tardive dyskinesia, and their occurrence worsens significantly patient's quality of life and compliance. Drug-induced parkinsonism, akathisia and acute dystonias can be managed with well known strategies and their reduction is one of the main target of the development of new 'atypical' antipsychotic agents. In this review we will discuss epidemiology, including risk factors, physiopathology, clinical aspects and treatment of each acute neuroleptic-induced exrapyramidal disorder. We will report also original data about the prevalence of acute extrapyramidal disorders, presented during the meeting 'Physiopathological and clinical aspects of neuroleptic-induced extrapyramidal disorders', held in Milan on November 24, 1993 at the S. Raffaele Hospital (I.R.C.C.S.) and organized by the third Chair of Clinical Psychiatry of the university of Milan and by the I.R.G.A.S.D.