Extrapyramidal side effects as a consequence of treatment with neuroleptics

Abstract

Objective: To check the occurrence of extrapyramidal side effects inpatients receiving neuroleptic drugs, how these effects are treated,and to observe the occurrence of hallucinations caused by treatmentof extrapyramidal symptoms. Methods: The present study analyzedmedical records and interviewed 39 schizophrenic patients beingtreated in a public primary care clinic located in the southern partof the city of São Paulo, who had previously agreed to participatein the project. Results: Among 39 patients studied, 85% presentedextrapyramidal symptoms. Of these, 69.7% were treated for theside effects, 73.9% were treated with biperiden and 26.09% hadtheir neuroleptic drug reduced. Out of those patients treated withbiperiden, 70.5% had side effects, such as hallucination and delusion,blurred vision, somnolence and verbal memory deficit. Conclusions:The majority of patients (85%) undergoing treatment with neurolepticdrugs developed motor side effects. When these extrapyramidalsymptoms were treated with central action anticholinergic drugs(biperiden), hallucination and/or delusion occurred in 52.94% ofpatients – probably because of increased dopaminergic activity asa consequence of cholinergic activity reduction caused by biperidenin the mesocortical and mesolimbic pathways.

Keywords

• Antipsychotic agents/adverse effects
• Cholinergic antagonists
• Biperiden/therapeutic use
• Schizophrenia/drug therapy