They may include one or more of the following and last indefinitely even after cessation of the<unk> , especially after long-term or high-dosage use: * Cardiovascular diseasethumb * Extrapyramidal symptoms (EPS) associated with typical antipsychotics: * Early stage – occurs at onset of treatment or following increased dose, patients recover when dose is decreased * Acute dystonias – muscle spasms and sustained abnormal postures and onset occurs within a few days; can be treated with anticholinergics * risk factors include age, gender and family history * Akathisia - pacing and restlessness and onset occurs within the first few months; can be treated with beta blockers and benzodiazepines * Parkinsonism due to effects on the nigrostriatal pathway - includes tremors, bradykinesia and muscle rigidity * risk factors include age and gender * Late stage – occurs after prolonged (months-years) treatment, symptoms persist even after dose is decreased * Tardive dyskinesia - includes involuntary and repetitive facial movements * risk factors include age, race and gender * It is hypothesized that these effects are due to chronic blockade of the D2 receptor * Hyperprolactinaemia due to blockade of the D2 receptors in the anterior pituitary leading to increased prolactin release * Increased appetite including increased craving and binge eating that lead to weight gain * Increased risk for insulin resistance * Sexual dysfunction * Metabolic changes with increased risk of obesity and diabetes mellitus type 2 * Sedation *Neuroleptic Malignant Syndrome is a medical emergency caused by a decrease in dopaminergic activity, resulting in a central D2 receptor blockade.
Dopamine antagonist
Dopamine agonist
Alpha-adrenergic agonist
Opioid antagonist
Norepinephrine–dopamine disinhibitor
Norepinephrine reuptake inhibitor
Serotonin receptor agonist
Muscarinic antagonist