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	Extrapyramidal system - Wikipedia, the free encyclopedia
		The extrapyramidal system can be affected in a number of ways, which are revealed in a range of extrapyramidal symptoms such as akinesia and akathisia.
		Extrapyramidal side effects (EPS) are the various movement disorders such as tardive dyskinesia suffered as a result of taking dopamine antagonists, usually antipsychotic (neuroleptic) drugs, which are often used to control psychosis, especially schizophrenia.
		Extrapyramidal symptoms can also be caused by brain damage, as in athetotic cerebral palsy, which is involuntary writhing movements caused by perinatal brain damage.
	en.wikipedia.org /wiki/Extrapyramidal_system (359 words)

	Clinical Geriatrics
		Extrapyramidal symptoms and tardive dyskinesia are associated with incoordination, feeding problems, disfigurement, social isolation, falls, and fractures.
		Aripiprazole is efficacious for psychiatric symptoms of Alzheimer’s disease and exhibits a favorable safety and tolerability profile for the geriatric population.
		Extrapyramidal symptoms and tardive dyskinesia are associated with incoordination, disfigurement, falls, and fractures.
	www.clinicalgeriatrics.com /cg/displayArticle.cfm?articleID=cgsupp1955 (5159 words)

	Extrapyramidal symptoms due to dopamine-blocking agents in patients with AIDS encephalopathy.
		Extrapyramidal symptoms due to dopamine-blocking agents in patients with AIDS encephalopathy.
		The likelihood of developing extrapyramidal symptoms was 2.4 times as high among the AIDS patients as among the comparison group.
		Such symptoms were developed by 50% of the AIDS patients who received less than 4 mg/kg of chlorpromazine equivalents per day and 78% of those who received more than 4 mg/kg per day.
	www.aegis.com /aidsline/1992/jan/M9210059.html (449 words)

	Triavil Side Effects, and Drug Interactions - Perphenazine and Amitriptyline - RxList Monographs (Site not responding. Last check: 2007-10-06)
		CNS Effects: Extrapyramidal reactions: opisthotonus; trismus; torticollis; retrocollis; aching and numbness of the limbs; motor restlessness; oculogyric crisis; hyperreflexia; dystonia, including protrusion, discoloration, aching and rounding of the tongue; tonic spasm of the masticatory muscles; tight feeling in the throat; slurred speech; dysphagia; akathisia; dyskinesia; parkinsonism; and ataxia.
		Extrapyramidal symptoms can usually be controlled by the concomitant use of effective antiparkinsonian drugs, such as benztropine mesylate, and/or by reduction in dosage.
		Serious anticholinergic symptoms (severe dry mouth, urinary retention, blurred vision) have been associated with elevations in the serum levels of the tricyclic antidepressant when cimetidine is added to the drug regimen.
	www.rxlist.com /cgi/generic2/etrafon_ad.htm (1984 words)

	Risperidone (Risperdal) Antipsychotics
		This blockade, however, is considered responsible for the appearance of extrapyramidal symptoms.
		In the mesocortical tract, dopamine blockade may be responsible for the negative symptoms of schizophrenia.
		By antagonizing dopamine in all areas of the brain, conventional antipsychotics are effective for the positive symptoms of schizophrenia, but exacerbate negative symptoms and extrapyramidal effects.
	www.rockford.uic.edu /jc/risperid.htm (644 words)

	American Psychiatric Association (Site not responding. Last check: 2007-10-06)
		A patient with a first episode of symptoms characterizing schizophrenia may indeed be experiencing a schizophrenic episode or the onset of schizophreniform disorder, or he or she may be having an episode of another illness or disorder that can cause similar symptoms.
		If negative symptoms persist in the absence or after adequate treatment of associated extrapyramidal side effects or depressive, anxiety, or positive symptoms, patients are presumed to have primary negative symptoms of the deficit state.
		Generally, depressive symptoms that occur with acute psychotic symptoms are treated sequentially; that is, antipsychotic medications are used first to treat the acute psychosis.
	www.psych.org /psych_pract/treatg/pg/pg_schizo_5.cfm (5323 words)

	Extrapyramidal Side Effects
		Extrapyramidal symptoms are caused by dopamine blockade or depletion in the basal ganglia; this lack of dopamine often mimics idiopathic pathologies of the extrapyramidal system.
		Less recognized is that extrapyramidal symptoms are also associated with certain non-antipsychotic agents, including some antidepressants, lithium, various anticonvulsants, antiemetics and, rarely, oral-contraceptive agents.
		Extrapyramidal symptoms caused by these agents are indistinguishable from neuroleptic-induced extrapyramidal symptoms.
	www.angelfire.com /journal2/sadhelp/eps.htm (1813 words)

	Use of atypical antipsychotic drugs in patients with dementia - Clinical Pharmacology American Family Physician - Find ...
		Psychotic symptoms in elderly patients always should be investigated thoroughly, and underlying medical conditions should be identified and treated.
		Extrapyramidal symptoms can cause stiffness, immobility, and falls and are associated with significant morbidity.
		(5) Psychotic symptoms are present in at least 25 percent of mildly demented patients with Alzheimer's disease and in 50 percent of patients with advanced Alzheimer's disease.
	www.findarticles.com /p/articles/mi_m3225/is_11_67/ai_102822648 (779 words)

	[No title]
		The symptoms of schizophrenia fall into two categories, positive symptoms that include thought disorders, hallucinations and delusions of grandeur, persecution and control, and negative symptoms that include flattened emotional response, poverty of speech, lack of initiative or persistence, anhedonia and social withdrawal (Carlson, 1998).
		Some evidence suggests that positive symptoms involve excess activity in the neural circuits that use dopamine, and negative symptoms have been correlated with damage to the medial temporal lobes, the frontal lobes, and the medial diencephalons (Carlson, 1998).
		Symptom reduction is dependent upon continued treatment, forty percent of patients relapse within six months, and seventy percent relapse within a year of discontinuance of the medication (Spohn, Strauss, 1989).
	sorrel.humboldt.edu /~morgan/neur_s03.htm (1045 words)

	Evidence of Neuroleptic Drug-Induced Brain Damage in Patients: A partial, Annotated Bibliography
		Among the EPS-diagnosed patients, Parkinsonism as assessed by the presence of core Parkinsonian symptoms (rigidity, tremor, bradykinesia) was present in 65.9% of patients (N = 302), akathisia in 31.8% (N = 145), and acute dystonia in 2.1% (N = 10).
		The symptoms were treated with anticholinergic medication and by an increase in dose of olanzapine to 20 mg/day.
		Symptoms of psychosis were improved in nine of 12 patients, but nine of 12 patients also experienced worsening of motor functioning while on OLZ.
	www.namiscc.org /Research/2003/NeurolepticInducedBrainDamage.htm (9056 words)

	Extrapyramidal Signs (Site not responding. Last check: 2007-10-06)
		These physical symptoms, which include tremors, rigidity, and slowness of movement, resemble the symptoms of Parkinson's disease.
		However, in many instances, the cause of extrapyramidal signs in patients with Alzheimer's disease is not clear.
		The researchers used autopsies to confirm the findings in the Alzheimer's cases, exploring sections of the substantia nigra and basal ganglia for pathological changes, since pathology in these areas is known to produce a variety of extrapyramidal signs.
	cpmcnet.columbia.edu /news/frontiers/archives/biomed_v4n3_0005.html (276 words)

	GENERAL GUIDELINES
		Studies indicate that it is at least as effective for acute symptoms as the typical neuroleptics and that it has a very low risk for causing extrapyramidal symptoms.
		The beneficial impact of these drugs is greatest on psychotic symptoms, particularly hallucinations and delusions in the early and midterm stages of the disorder.
		Extrapyramidal side effects may actually mimic those of Parkinson's disease (caused by too little dopamine), and so physicians may prescribe anti-parkinsonism drugs known as anticholinergics which increase dopamine levels and help to restore balance.
	www.meta-religion.com /Psychiatry/Disorders/treating_schizophrenia.htm (2552 words)

	Family history of primary movement disorders as a predictor for neuroleptic-induced extrapyramidal symptoms -- Lencer ...
		of symptoms), dystonia and psychiatric disorders in first-degree
		or gender as a predictor for the occurrence of symptoms.
		Gil-ad, L., Shtaif, B., Shiloh, R., et al (2001) Evaluation of the neurotoxic activity of typical and atypical neuroleptics: relevance to iatrogenic extrapyramidal symptoms.
	bjp.rcpsych.org /cgi/content/full/185/6/465 (3141 words)

	Extrapyramidal symptoms not ‘robust’ indicator of later tardive dyskinesia (Site not responding. Last check: 2007-10-06)
		Extrapyramidal symptoms not ‘robust’ indicator of later tardive dyskinesia
		Among 10,000 patients with schizophrenia, occurrence of early extrapyramidal symptoms (EPS) was associated with a 2-fold increase in risk of tardive dyskinesia (TD) 1 year later, according to an article published in the August issue of the American Journal of Psychiatry.
		But of course, the other half of patients with TD did not have these earlier symptoms, leading the researchers to conclude that the relationship is important but not robust enough to identify specific individuals at risk.
	www.pharmacist.com /articles/h_ts_1212.cfm (359 words)

	Extrapyramidal symptoms (EPS) (via CobWeb/3.1 planetlab2.cs.virginia.edu) (Site not responding. Last check: 2007-10-06)
		Extrapyramidal symptoms, often abbreviated EPS, is a neurological side effect of antipsychotic medication.
		Sometimes the symptoms of medication induced parkinsonism may be confused with the negative symptoms caused by the schizophrenic disease itself.
		Akathisia is a condition associated with the use of certain medications and characterized by an internal sense of motor restlessness often described as an inability to resist the urge to move.
	www.hubin.org.cob-web.org:8888 /publicfamilyinfo/treatment/side_effects/side_effects_6_en.html (465 words)

	Team projects on www for Psychopharmacology
		Someargue that the reduction of negative symptoms seen in clozapine treated patients is merely secondary toa reduction of positive symptoms and extrapyrimidial side effects (Breier et al, 1994).
		In nondeficit schizophrenia, negative symptoms areconsidered secondary to the illness.
		Theseconclusions are based on the results that almost all of the improvement of negative symptoms occurredtogether with improvements in positive symptoms and extrapyrimidial side effects.
	www.humboldt.edu /~morgan/clozapi2.htm (8694 words)

	Amantadine - Parkinson's disease medication information and resources (Site not responding. Last check: 2007-10-06)
		Amandatine is useful in the treatment of Parkinson's syndrome and in the short-term management of drug-induced extrapyramidal symptoms.
		Although anticholinergic-type side effects have been noted when used in patients with drug-induced extrapyramidal reactions, there appears to be a lower incidence of these side effects than that observed with anticholinergic antiparkinson drugs.
		Therefore, amantadine may be used in the management of extrapyramidal symptoms which cannot be controlled by reduction of neuroleptic dosage, but should be discontinued as soon as it is no longer required.
	www.nwpf.org /amantadine.asp (2396 words)

	SCHIZOPHENIA (Site not responding. Last check: 2007-10-06)
		Negative symptoms tend to be more common than positive symptoms in older patients and typically persist after positive symptoms have been treated.
		Given the fact that schizophrenic symptoms naturally elicit negative responses from the sufferer's circle of family and acquaintances, it is safe to assume that negative feedback can intensify deficits in a vulnerable brain and perhaps even trigger and exacerbate existing symptoms.
		Shared symptoms include delusions, hallucinations, disorganized and incoherent speech, a flat tone of voice, and bizarrely disorganized or catatonic behavior (such as lack of speech, muscular rigidity, and unresponsiveness).
	www.reutershealth.com /wellconnected/doc47.html (9279 words)

	News - Risperidone and Olanzapine May Reduce Risk of Extrapyramidal Symptoms
		Risperidone and olanzapine also were associated with a reduced risk of extrapyramidal symptoms irrespective of previous use of antiparkinsonian medication.
		On the other hand, was no significant difference in the likelihood of developing extrapyramidal symptoms among those taking risperidone and who had a history of such symptoms compared to those taking haloperidol: the relative risk was 1.30.
		They conclude that risperidone and olanzapine seem to be associated with a reduced risk of extrapyramidal symptoms compared to haloperidol in patients with similar treatment histories.
	docguide.com /news/content.nsf/news/852569780017887A85256B3B004DACC3 (544 words)

	Risperdal® (risperidone) produces continuous improvement of 'manic' symptoms in bipolar disorder
		Treatment with Risperdal also was associated with a lower incidence of extrapyramidal symptoms (movement disorders) than the older conventional antipsychotic haloperidol, which should make it easier for more patients to take their medication consistently.
		One of the potential risks associated with treating bipolar patients with manic symptoms is the possibility of triggering depression.
		In this study, Risperdal treatment improved symptoms of depression in patients with bipolar disorder.
	www.eurekalert.org /pub_releases/2003-09/rc-rp092203.php (764 words)

	NAMI-NYS
		The drug helps manage schizophrenia's positive symptoms (e.g., visual and auditory hallucinations, delusions, and thought disturbances) and may also help treat the illness’ negative symptoms (e.g., social withdrawal, apathy, lack of motivation, and inability to experience pleasure).
		Risperdal also offers the advantages of helping treat negative symptoms and causing fewer extrapyramidal side effects (EPS) such as restlessness, muscle rigidity, and tremor when taken at the manufacturer's recommended dose of 6 mg per day or less.
		Should symptoms of TD develop, such as grimacing, sucking and smacking of lips, and other spasmodic movements, discontinuation of Risperdal should be considered.
	www.naminys.org /abmed_ris.htm (669 words)

	eMedicine - Toxicity, Neuroleptic Agents : Article by Kathryn Challoner, MD, MPH, FACEP (Site not responding. Last check: 2007-10-06)
		Several forms of extrapyramidal symptoms (EPS) are associated with neuroleptic toxicity.
		Symptoms generally present within 6 hours of ingestion; thus, monitoring patients for at least 6 hours is wise.
		Gil-ad I, Shtaif B, Shiloh R, Weizman A: Evaluation of the neurotoxic activity of typical and atypical neuroleptics: relevance to iatrogenic extrapyramidal symptoms.
	www.emedicine.com /emerg/topic338.htm (5972 words)

	PHCL 3720 Lecture 20
		In selecting for least extrapyramidal effects, thioridazine and clozapine and the other atypical antipsychotic agents (olanzepine and risperidone) produce the lowest incidence of extrapyramidal side effects.
		Drugs producing the lowest incidence of extrapyramidal symptoms also have the highest central anticholinergic activity (except for risperidone).
		Symptoms include hyperpyrexia, muscle rigidity, catatonia, autonomic instability (irregular pulse, blood pressure, or heart rate, or sweating).
	www.neurosci.pharm.utoledo.edu /PHCL3720/Lecture20.htm (1095 words)

	Extrapyramidal symptoms and signs in first-episode, antipsychotic exposed and non-exposed patients with schizophrenia ...
		Extrapyramidal symptoms and signs in first-episode, antipsychotic exposed and non-exposed patients with schizophrenia or related psychotic illness -- Honer et al.
		Articles by Honer, W. Articles by Rabinowitz, J. Extrapyramidal symptoms and signs in first-episode, antipsychotic exposed and non-exposed patients with schizophrenia or related psychotic illness
		symptoms were correlated; however, the effect sizes were
	jop.sagepub.com /cgi/content/abstract/19/3/277 (232 words)

	Parkinsonism
		He argued that extrapyramidal reactions were unusual at the recommended daily dose and that they occurred primarily in patients with subclinical PD. He pointed out that the extrapyramidal symptoms during flunarizine treatment may not be drug-related since flunarizine is often prescribed to older patients, who are themselves at an increased risk of parkinsonism.
		Disappearance of symptoms after removal of cinnarizine/flunarizine could simply be related to the simultaneous suspension of levodopa.
		Interestingly they have found significant results only for those symptoms in which the groups were clearly different in their means at baseline (not significantly different in statistical terms, but with such lack of power to detect differences...).
	www.hsph.harvard.edu /Organizations/DDIL/parkins.html (3018 words)

	ECNP: Sertindole Superior to Haloperidol for Extrapyramidal Symptoms in Schizophrenic Patients (Site not responding. Last check: 2007-10-06)
		BARCELONA, SPAIN -- October 9, 2002 -- Sertindole is effective for treatment of psychosis, including negative symptoms, and is superior to haloperidol for extrapyramidal symptoms (EPS) and use of anti-EPS medication.
		Five hundred and ninety five patients were treated with sertindole 8, 16, 20, or 24 mg/day or haloperidol 10 mg/day for up to eight weeks.
		Inclusion criteria included DSM-III-R primary diagnosis of schizophrenia, two of four items of PANSS (Positive and Negative Symptoms Scale), with item scores of 0 or less to 2, and with the sum of any two items at 8 or greater.
	www.pslgroup.com /dg/21FE72.htm (507 words)

	Risperidone and Cognition (Site not responding. Last check: 2007-10-06)
		Two decades ago, cognitive deficits in schizophrenia were linked predominantly to the Type II syndrome, along with chronicity, negative symptoms, extrapyramidal symptoms, and radiological evidence of cortical atrophy and ventricular dilatation.
		However, control of positive symptoms, avoidance of anticholinergic effects, and enhancement of prefrontal dopaminergicity are all psychopharmacological possibilities.
		All patients had symptoms that were at least mild in severity.
	www.indegene.com /Psy/FeatArt/indPsyFeatArt7.html (1277 words)

	Empirical Validation of Primary Negative Symptoms: Independence From Effects of Medication and Psychosis -- Kelley et ... (Site not responding. Last check: 2007-10-06)
		Tollefson GD, Sanger TM: Negative symptoms: a path analytic approach to a double-blind, placebo- and haloperidol-controlled clinical trial with olanzapine.
		Fenton WS, McGlashan TH: Antecedents, symptom progression, and long-term outcome of the deficit syndrome in schizophrenia.
		Liddle PF: The symptoms of chronic schizophrenia: a re-examination of the positive-negative dichotomy.
	ajp.psychiatryonline.org /cgi/content/full/156/3/406 (3129 words)

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