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What Are Extrapyramidal Effects?

Medically Reviewed by Jabeen Begum, MD on October 26, 2021

The term "extrapyramidal effects" describes involuntary movements that you cannot control. These side effects are most common when taking antipsychotic medications?

When you experience extrapyramidal effects, movements that were once voluntary happen without your control. Examples of extrapyramidal effects include:

  • Akathisia: Feeling restless like you can’t sit still. You may have the urge to tap your fingers, fidget, or jiggle your legs.
  • Dystonia: When your muscles contract involuntarily. It can be painful.
  • Parkinsonism: Symptoms are similar to Parkinson’s disease. You may have a tremor, difficulty finishing thoughts or speaking, and stiff facial muscles. ‌But while a loss of nerve cells causes Parkinson’s disease, the medication causes Parkinsonism.
  • Tardive dyskinesia: Facial movements happen involuntarily. You may make a sucking or chewing motion with your mouth, stick out your tongue, or blink your eyes a lot. 

What Are Antipsychotic Medications?

‌Doctors prescribe antipsychotic medications to treat psychosis. Mental health conditions in this category can lead to delusions or hallucinations. Many psychosis disorders are not curable.

‌Antipsychotic medications work because they have dopamine-blocking agents, which can lead to extrapyramidal effects.

How Are Extrapyramidal Side Effects Diagnosed?

Often other people notice involuntary movements before you do. If you take an antipsychotic medication, talk to your loved ones and close friends about the potential side effects. They may be able to help you identify extrapyramidal effects early on.

You can also be more aware of your movements. Do you suddenly find yourself fidgeting or moving more than usual? What happens when you try to stop or control the movements? If you have concerns about anything new you experience, talk to your doctor.

When you talk to your doctor, they may ask about the specific signs of extrapyramidal effects that you, your friends, or your family observe. They may also ask questions about when you or your loved ones first noticed the symptoms. Your doctor wants to make sure these symptoms weren’t present before starting your antipsychotic medication.

How Are Extrapyramidal Side Effects Treated?

Extrapyramidal symptoms caused by medication aren’t usually treated separately. Instead, your doctor may try a lower dose or a completely different medication.

In some cases, a doctor may prescribe lipophilic beta-blockers, benzodiazepines, or anticholinergics to lessen the side effects of antipsychotic medications.

Show Sources

SOURCES:

Drug Safety Journal: “Managing antipsychotic-induced acute and chronic akathisia.”

National Institute of Mental Health: “Mental Health Medications.”

Psychiatry (Edgemont) Journal: “Antipsychotic-Induced Movement Disorders.”

U.S. Food and Drug Administration: “Why You Need to Take Your Medications as Prescribed or Instructed.”

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