Extrapyramidal Side Effects (EPSEs) of Antipsychotic Medications : Introduction

Antipsychotic agents are pivotal in the pharmacological management of psychiatric conditions such as acute and chronic schizophrenia, bipolar mood disorders, and other psychotic disorders. These agents are broadly categorized into two classes: first-generation antipsychotics (FGAs), also known as conventional or typical agents, and second-generation antipsychotics (SGAs), often referred to as atypical agents. While these medications are crucial in treating psychiatric disorders, they are not without their drawbacks. At therapeutic doses, antipsychotic medications exhibit a spectrum of effects, both beneficial and adverse.

One of the major adverse effects of antipsychotic medication is the occurrence of extrapyramidal side effects (EPSEs). EPSEs, also known as drug-induced movement disorders, encompass a variety of movement abnormalities. These side effects can be broadly classified into acute and tardive symptoms, including parkinsonism, dystonia, tardive dyskinesia (TD), and akathisia. EPSEs are primarily associated with the use of typical antipsychotic agents, although they can also occur with atypical agents.

The impact of EPSEs on patients is significant, often causing distress and exacerbating psychopathological states. These side effects can stigmatize patients and contribute to their reluctance to continue medication, thereby impacting treatment adherence. Additionally, EPSEs can complicate the clinical assessment of schizophrenia, particularly the negative symptoms, leading to potential misdiagnoses...