Neuroleptic-Induced Anguish, Including Agitation, Despair, and Depression

Neuroleptic-Induced Anguish, Including Agitation, Despair, and Depression 

Not all drug effects on the central nervous system can be categorized as spellbinding, but all produce disability. Often the result is a worsening of the patient s overall condition, and sometimes the result is an extremely distressing or disabling psychiatric reaction. Ironically, psychiatric drugs do not cure or ameliorate central nervous system disorders they cause them. 

Despite the lobotomy-like indifference to suffering produced by neuroleptic-induced deactivation, many patients experience varying degrees of physical and mental pain and torment in response to these drugs. The deactivation itself is often experienced as dreadful, a kind of living death or an imprisonment within one s own brain. 

This chapter will describe some of the most common, reversible, drug-induced neurological reactions acute dystonia acute akathisia parkinsonism and a broad, ill-defined category called dysphoria. All of them tend to begin early in treatment but can start later on as well. Chapters 4 and 5 will review the sometimes delayed and often persistent adverse reactions, including irreversible forms of akathisia and dystonia. 

Most of the neurological disorders associated with the neuroleptics fall into the category of extrapyramidal reactions or extrapyramidal symptoms, and are often designated EPS. The extrapyramidal system of the brain is an extensive, complex network that moderates and adjusts motor 

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