Thread by @Drug_Evidence

🧵 How well do you know your dopamine antagonists? 💊💊

1/ Using these drugs safely requires that clinicians & patients appreciate their important #AdverseEffects, which are not always well understood

👉🏽ti.ubc.ca/letter139

#MedEd #prescribing #deprescribing #medsafety

2/ #AdverseEffects may include:

⚠️ Drug-induced #Parkinsonism
-↘️ or slowed movements, rigidity/tremor/unsteadiness, facial expression loss

⚠️ #Akathisia
-intense internal restlessness or desire to move (which may be mistaken for anxiety)

👉🏽Pt videos: ti.ubc.ca/letter139

3/ #AdverseEffects may include:

⚠️Acute dystonic reaction
-sudden, involuntary, often painful muscle spasm

⚠️Dyskinesia
-repetitive, involuntary movements...can be associated with cognitive decline

👉🏽Pt experience videos: ti.ubc.ca/letter139

#MedEd #ptsafety #drugsafety

4/ Are “atypical #antipsychotics” different?

Clozapine causes fewer extrapyramidal symptoms, but other toxicities limit use

Newer 💊 such as olanzapine, quetiapine, risperidone, & many later drugs retain potential to cause serious neurological, metabolic, other problems #MedEd

5/ Avoid serious harms when #prescribing dopamine antagonists:

⚠️Prescribe only when essential

↘️Use lowest effective dose

⏳Cautious time-limited prescribing for ppl w/ psychotic disorders & for some LTC residents after non-drug options exhausted

👉🏽ti.ubc.ca/letter139

6/ CONCLUSIONS:

👨🏽‍🏫 Learn/teach dopamine blockade symptoms/signs

⚠️ Exclude causation by DA antagonists before applying terms like "restless legs" to pts

🩺 Look/listen for drug-induced Parkinsonism, akathisia, movement disorders during pt exams

💊 Reassess tx dose/duration

@threadreaderapp unroll, SVP