Effective pharmacologic treatment of schizophrenia has been available since the 1950s. The first-generation antipsychotics had an increased risk of extrapyramidal side effects, such as dystonic reactions (example, fixed upper gaze, neck twisting, facial muscle spasms), parkinsonian symptoms (example, rigidity, bradykinesia, shuffling gait, tremor), and akathisia (example, inability to sit still, restlessness, tapping of feet).