Monitoring for drug-induced movement disorders

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DRUG-INDUCED MOVEMENT DISORDERS (DIMDs) are associated with the use of first-generation antipsychotics (FGAs), also known as conventional or typical antipsychotics, as well as with second-generation antipsychotics (SGAs) or atypical antipsychotics. The term neuroleptics is sometimes used to refer to both FGAs and SGAs.
FGAs include drugs such as haloperidol, pimozide, thiothixene, and trifluoperazine. SGAs include drugs such as risperidone, paliperidone, and lurasidone. Antipsychotic medications may be prescribed to treat various psychiatric disorders such as schizophrenia and bipolar mania.1
Compared with FGAs, SGAs generally carry a lower risk of DIMDs, which include extrapyramidal side effects (EPS) and tardive dyskinesia (TD).
DIMDs reduce quality of life, decrease adherence to drug therapy, impair social relationships, and significantly compromise motor skills needed for activities of daily living (ADLs).5,6 DIMDs can be irreversible, but early detection and intervention can improve outcomes.7
Patients taking FGAs can be monitored for DIMDs with the Abnormal Involuntary Movement Scale (AIMS), a simple checklist that can be completed in about 10 minutes.8 This article discusses assessment considerations for nurses using the AIMS.

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