What are Movement Disorders?

Movement disorders cause either too much or insufficient movement, both voluntary and involuntary. These disorders occur without weakness or stiffness in the muscles. Movement disorders are the same as basal ganglia or extrapyramidal diseases. Movement disorders are classified into two main categories- hyperkinetic and hypokinetic, conventionally. Hyperkinetic movement disorders are dyskinesias, or excessive, frequently repetitive, involuntary movements that enter the normal flow of motor activity. Hypokinetic movement disorders include:

• Akinesia (absence of movement).
• Hypokinesia (reduced amplitude of movements).
• Bradykinesia (slow movement).
• Rigidity.

Abnormal movement is the primary manifestation of primary movement disorders, while in secondary movement disorders, abnormal movement is a manifestation of another systemic or neurological disorder.

What are the different types of disorders?

• Neuroleptic-induced Parkinsonism: Parkinson's-like tremors, rigidity, or changes in movement following a change in medication
• Neuroleptic malignant syndrome: hyperthermia (high body temperature) due to antipsychotic drugs, more specifically, a dopamine antagonist abstract representation. The individual depicted in the picture is pacing, and flames surround the figure.
• Medication-induced acute dystonia: involuntary contractions of muscles as an effect of medication
• Medication-induced acute akathisia: a sense of restlessness and agitation after medication
• Tardive dyskinesia: This condition causes involuntary and repetitive movements of the body. Symptoms may include grimacing, sticking out the tongue, or smacking the lips.
• Tardive dystonia: This condition involves permanent muscle contractions that cause twisting and repetitive movements or unusual fixed postures.
• Tardive akathisia: This condition leads to painful feelings of inner tension and anxiety, along with a strong urge to move the body.

Can medication cause movement disorders?

Yes. Many drugs can cause movement disorders. Movement disorders caused by drugs can appear within hours, days, or weeks after drug exposure.

Which medication causes more common movement disorders?

Many drugs may cause movement disorders. The most commonly used drugs that may cause movement disorders are:

• Antipsychotics and other psychotropics are used to treat psychiatric symptoms. Such drugs may include fluphenazine, chlorpromazine, promazine, pimozide, haloperidol, perphenazine, risperidone, lithium, reserpine, and others.
• Prokinetic or antiemetics are drugs used against nausea and other gastroenterological issues. These drugs include metoclopramide, promethazine, prochlorperazine, levosulpiride
• Antihistaminics are drugs used for allergies and include hydroxyzine and promethazine.
• Antiepileptics are drugs used against seizures and include valproate, phenytoin, and others.

Are medication-induced movement disorders treatable?

Yes. They may be treatable, but treatment is individualized and needs to be discussed with your treating physician. In most cases, the offending drug will be stopped and replaced by another drug by your physician, depending on the underlying disease for which you were prescribed these drugs. This may need to take a while, as well as some of these drugs cannot be stopped abruptly. Some medications that directly target the improvement of these symptoms, such as VMAT2 inhibitors, are prescribed by physicians. In extreme instances, it may be an option of surgical approach: Deep brain stimulation. 

What should I do if I take such medication and experience movement disorders?

Take medication that may cause movement disorders and you experience symptoms such as involuntary movements, slowness, and constant urge to move, or discomfort. It would help if you talked to your doctor as soon as possible. You should not stop your medication by yourself because an abrupt withdrawal of such drugs may cause dangerous side effects. At the same time, you should not ignore the symptoms as sometimes time is an essential factor in treating such movements.

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