What are extrapyramidal symptoms and how are they monitored?

• A. Extrapyramidal symptoms include acute dystonia, akathisia, pseudoparkinsonism, and tardive dyskinesia; monitored with regular motor assessments and scales like the AIMS.
• B. Extrapyramidal symptoms are mood disturbances and monitored with the HAMD.
• C. Extrapyramidal symptoms are unrelated to antipsychotics and monitored with the GCS.
• D. Extrapyramidal symptoms involve cognitive impairment and monitored with the MMSE.

Answer: (A)

Extrapyramidal symptoms are movement disorders caused by blocking dopamine in the nigrostriatal pathway with antipsychotic medications. The main manifestations include acute dystonia (sudden, painful muscle contractions), akathisia (a subjective restlessness with an urge to move), pseudoparkinsonism (trozen-like tremor, rigidity, and slowed movement), and tardive dyskinesia (late-onset, involuntary, choreiform movements of the face, tongue, and limbs). Because these symptoms reflect drug effects on motor control rather than the psychiatric condition, they’re monitored with regular motor assessments using standardized tools, with the Abnormal Involuntary Movement Scale (AIMS) being a common and validated method to quantify involuntary movements over time. A baseline assessment before starting treatment, followed by periodic checks (more frequent early in therapy), helps detect emergence or progression of EPS and guides adjustments to the antipsychotic regimen or the addition of targeted treatments.