Clinical Assessment and Medicinal Management of Extrapyramidal Symptoms Induced by Some Antipsychotics in Iraqi Patients

Abstract Background: The extrapyramidal symptoms represent one of the most dramatic drug-induced side effects including Parkinson’s - like symptoms , dystonia, and akathisia that can be associated with the use of all typical antipsychotic agents. Objectives: Assessment of the extrapyramidal symptoms induced by typical antipsychotics and their medical management with anti-Parkinsonian drugs. Materials and Methods: Fifty psychotic patients among those attending the outpatient clinic of the psychiatric unit in the Al-Sadiq Teaching Hospital in Babylon province were enrolled in this retrospective case–control study, from the period August 2021 to February 2023. Demographic data (age, gender, and marital status), medical, and psychiatric history (such as suicide attempts, time and location of the incident) were collected. Chlorpromazine, haloperidol, and trifluoperazine were used as antipsychotics. Through 1 month of follow-up, the anti-Parkinsonian drugs trihexyphenidy and procyclidine were prescribed to patients who experienced extrapyramidal side effects. Result: Fifty-two percent of the patients experienced extrapyramidal side effects (24% Parkinson-like symptoms, 18% dystonia, and 10% akathisia), which were mild, moderate, and severe in 13%, 12%, and 27% patients, respectively. All dystonic reactions were treated with procyclidine and trihexyphenidy. Patients not controlled by these treatments were changed to another neuroleptic drug with less extrapyramidal side effects. Conclusion: Extrapyramidal side effects are the most frequent medical disorders that are associated with antipsychotic usage, and they can be managed by anti-Parkinsonian drugs.