2020
DOI: 10.1177/0269881120944156
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Neurobiological mechanisms associated with antipsychotic drug-induced dystonia

Abstract: Dystonia is by far the most intrusive and invalidating extrapyramidal side effect of potent classical antipsychotic drugs. Antipsychotic drug-induced dystonia is classified in both acute and tardive forms. The incidence of drug-induced dystonia is associated with the affinity to inhibitory dopamine D2 receptors. Particularly acute dystonia can be treated with anticholinergic drugs, but the tardive form may also respond to such antimuscarinic treatment, which contrasts their effects in tardive dyskinesia. Combi… Show more

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Cited by 32 publications
(35 citation statements)
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“…While the reason for this effect is not completely clear, it is thought to be related to dopaminergic dysregulation and considered to be within the EPS group [64]. Dystonia, akathisia, and parkinsonism are known psychomotor symptoms related to central dopaminergic dysregulation [65], and in the case described, they appeared quickly, within a few days, causing a major impact on the quality of life. These EPSs were refractory to symptomatic treatments and regressed only after the suspension of the antipsychotics in use.…”
Section: Discussionmentioning
confidence: 86%
“…While the reason for this effect is not completely clear, it is thought to be related to dopaminergic dysregulation and considered to be within the EPS group [64]. Dystonia, akathisia, and parkinsonism are known psychomotor symptoms related to central dopaminergic dysregulation [65], and in the case described, they appeared quickly, within a few days, causing a major impact on the quality of life. These EPSs were refractory to symptomatic treatments and regressed only after the suspension of the antipsychotics in use.…”
Section: Discussionmentioning
confidence: 86%
“…Only a handful of cases of domperidone-related dystonia and tardive dyskinesia have been published as yet [ 2 , 3 , 8 ], largely in the pediatric population ascribed to under-developed BBB or the elderly age group where the BBB permeability adjusts due to altered protein expression amidst neuronal modulation [ 3 ]. Table 1 enlists few drugs studied to cause EPS [ 3 , 4 , 9 , 10 ] and Table 2 illustrates the differentials that can be contemplated while evaluating a case of drug-induced movement disorders (DIMD) [ 3 , 5 , 11 ].…”
Section: Discussionmentioning
confidence: 99%
“…Although the precise mechanism of drug-induced dystonia is still in dilemma [ 9 , 13 ], this could be explicated similar to the off-state of Parkinson’s disease (PD) (a hypokinetic state of PD), particularly off drug dystonic state or drug naïve dystonia cases of PD (implying non-dopamine state). The direct striatopallidal pathway goes inhibited and indirect one is activated relaying further to precipitate an outburst of neuronal excitability (high frequency discharge) of subthalamic nucleus (STN).…”
Section: Discussionmentioning
confidence: 99%
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