Motor and mental aspects of extrapyramidal syndromes

Neuroleptic-induced extrapyramidal syndromes (EPS) are major limitations to effective antipsychotic therapy. There are both motor (objective) and mental (subjective) components to EPS, which must be considered in the evaluation and differential diagnosis of treatment-related adverse events. In addition to causing motor impairment, these syndromes can also produce irritability, anxiousness and secondary negative symptoms of slow thinking and emotional blunting. The EPS of akathisia, dystonia, and parkinsonism have unique characteristics that are influenced by patient, drug and temporal aspects. With the advent of new and novel antipsychotic drugs that have low EPS liability, patients will have fewer side effects, be less non-compliant and more able to benefit from rehabilitation efforts.