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Drug-Induced Movement Disorders
Katherine L. Claxton, PharmD
Aurora Sinai Medical Center, Department of Pharmacy, 945 N State St, Milwaukee, WI 53233
Jack J. Chen, PharmD, BCPS, CGP
Schools of Medicine and Pharmacy, Loma Linda University, 11262 Campus St, West Hall, Loma Linda, CA 92350, jjchen{at}llu.edu
David M. Swope, MD
Department of Neurology and School of Medicine, Loma Linda University, Loma Linda, CA 92350
Drug-induced movement disorders (DIMDs) pose a significant burden to patients, often resulting in nonadherence, disease relapse, and decreased quality of life. Dopamine-receptor blocking agents such as conventional antipsychotics (eg, haloperidol and chlorpromazine) and antiemetics (eg, metoclopramide and prochlorperazine) are most commonly implicated. DIMDs can be categorized by the onset of symptoms: acute reactions occurring hours to days after exposure, subacute DIMDs appearing within weeks, and tardive occurring months to years after drug exposure. The DIMDs of akathisia, tardive dyskinesia, dystonia, and parkinsonism are reviewed. Their epidemiology, mechanism, clinical presentation and differential diagnosis, risk factors, morbidity and mortality, and prevention and management are discussed. For many of these disorders, treatment inconsistently provides benefit, and therefore, primary prevention is essential. Clinicians and other healthcare professionals play a key role in the identification of patients with DIMDs, or those at risk, and in implementing prevention and treatment plans.
Key Words: Akathisia • dystonia • movement disorders • parkinsonism • tardive dyskinesia.
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Journal of Pharmacy Practice, Vol. 20, No. 6,
415-429 (2007)
DOI: 10.1177/0897190007310514
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