A Guide to the Extrapyramidal Side-Effects of Antipsychotic Drugs / Edition 2

by D. G. Cunningham Owens

Overview

It is often implied that antipsychotic-induced extrapyramidal side-effects are irrelevant to modern psychiatric therapeutics, rendered historic by newer, better treatments. This myth arises from limited awareness of the depth and breadth of neurological disruption antipsychotics can mediate. This volume discusses the extensive clinical boundaries of acute dystonias, drug-induced parkinsonism, akathisia and tardive dyskinesia, providing demographic and epidemiological context while illustrating how prescribing choices impact powerfully on their development. This new edition has been thoroughly updated and rewritten to include recent data, expanded references and a new chapter on the concept of 'atypical' antipsychotics. Written in a light, engaging style, liberally illustrated with clinical examples, it also invites readers to consider ongoing controversies - subjective drug effects, the relationship between 'akathisia' and restless legs, the status of the concept of 'atypicality', and so on. Informative reading for trainees as well as established practitioners in the fields of psychiatry, neurology, primary care and geriatrics.

Product Details

ISBN-13:	9781107022867
Publisher:	Cambridge University Press
Publication date:	04/10/2014
Edition description:	New Edition
Pages:	383
Product dimensions:	7.60(w) x 9.92(h) x 0.87(d)

About the Author

D. G. Cunningham Owens is Professor of Clinical Psychiatry, University of Edinburgh, and Honorary Consultant Psychiatrist, Royal Edinburgh Hospital, Edinburgh, UK.

Table of Contents

Preface; Part I. Setting the Scene: 1. The origins of psychopharma; 2. Some preliminaries; Part II. The Syndromes: 3. Acute dystonias; 4. Parkinsonism; 5. Akathisia; 6. Tardive dyskinesia; Part III. Particular Issues: 7. Tardive and chronic dystonia; 8. Special populations; Part IV. Assessment: 9. The clinical examination; 10. An overview of some standardised recording instruments; Part V. Matters Arising: 11. Involuntary movements and schizophrenia: a limitation to the concept of tardive dyskinesia?; 12. And finally … the salutary tale of 'atypicality'; References; Index.

Editorial Reviews

Reviewer: Michael Schrift, DO (University of Washington School of Medicine)
Description: This is a thoroughly engaging update of an honest account of the benefits and risks of antipsychotic drugs with articulate debunking of the commonly disseminated myths surrounding this class of drugs: differential effects of "conventional" versus "atypical" neuroleptics on tardive dyskinesia, negative symptoms, psychosis, and whether atypicality is a valid concept at all. It is a refreshing wakeup call to the field of psychiatry/psychopharmacology - a field that has unfortunately stagnated and been crippled by pharmaceutical company and "thought-leader" propaganda.
Purpose: The purpose of this edition is "to raise the standard once again and come out fighting to nudge and jostle EPS (extrapyramidal side effects) back to their rightful position at the center of risk-benefit appraisals" The author succeeds in demonstrating the need to pay attention to EPS with this needed second edition.
Audience: The target audience is anyone who prescribes dopamine receptor antagonists: psychiatrists, neurologists, primary care physicians, gastroenterologists, geriatricians, emergency medicine physicians, intensivists, nurses. and pharmacists. The author, who is an internationally recognized clinician-researcher in the field, provides his valuable personal insights on antipsychotic drug effects as well as wonderful descriptions of the clinical extrapyramidal syndromes.
Features: The first part is a summary of the history of the development of antipsychotic drugs and the recognition of movement abnormalities associated with the treatments and the illnesses. The second part details the clinical syndromes of acute dystonia, parkinsonism, akathisia, and tardive dyskinesia, all within a historical context. Part 3 discusses the phenomena of tardive and chronic dystonias as well as EPS in special populations such as children, adolescents, the learning disabled, and the elderly. The clinical assessment of patients and the utility of standardized rating scales are reviewed in part 4. The final part contains very interesting and enlightening chapters on spontaneous dyskinesias and the concept of so-called "atypicality." Each chapter contains relevant and timely citations of the scientific literature.
Assessment: This is an outstanding update of a very instructive book and should be mandatory reading for all trainees in psychiatry residency training programs — as well as their program directors! This book is like finding an oasis in a vast desert.

Doody's Review Service

"This is an outstanding update of a very instructive book and should be mandatory reading for all trainees in psychiatry residency training programs - as well as their program directors … This book is like finding an oasis in a vast desert."
Doody's Reviews

From the Publisher