Signs of Extrapyramidal Side Effects
| Sign | Onset | Manifestations |
|---|---|---|
| Akathisia (motor restlessness) | Sudden or gradual | Pacing, shifting from one foot to another when standing, tapping feet while sitting, inability to sit still, rocking, feeling something jumping out of skin, feeling anxious, feeling physically tense, tossing and turning in bed, feeling wired up |
| Dystonia (involuntary muscle contraction with rigidity) | Sudden | Neck twisting (torticollis), back arching or head pulling backward (opisthotonos), clenched jaw (trismus), eyes fixed upward (oculogyral crisis), difficulty speaking and swallowing with hypersalivation, inability to close eyes (blepharospasm), protruding tongue |
| Tardive dyskinesia (muscle spasms with late onset) | After months or years of antipsychotic use | Rapid blinking of the eyes; wormlike tongue; chewing with nothing in mouth; lip puckering; facial grimacing; rhythmic involuntary movements of jaws, face, extremities, and trunk |
| Pseudoparkinsonism (signs similar to those of Parkinson’s Disease) | Sudden or gradual | Shuffling gait; coarse tremor; drooling; fixed facial expression; apathy; slowness of voluntary movement; cogwheel rigidity in arms, shoulders, and neck; lead-pipe rigidity in torso and extremities, which become unmovable; rabbit syndrome (tremor of the lips and mouth) |