Patients at risk of permanent tardive dyskinesia include the elderly, the edentulous, and those with underlying organic cerebral dysfunction. Patients with affective illnesses appear more likely to develop tardive dyskinesia than patients with schizophrenia. They appear most frequently in young men and in patients already taking such drugs as lithium, calcium channel blockers, and SSRIs. Other acute movement disorders include dyskinesias, stereotyped behaviors in response to neuroleptics, and tics, which may occur in response to such CNS stimulants as methylphenidate, dextroamphetamine, and pemoline. Akathisia is a state of motor restlessness that involves an irresistible need to move.
Movement tends to alleviate the symptoms temporarily.
The restlessness is thought to be mediated by mesolimbic dopamine receptor blockade. Symptomatically, this may be related to restless legs syndrome. Therapy consists of removing the offending agent. When this is not possible, symptoms can be alleviated with benzodiazepines, anticholinergics, beta blockers, and, in some cases, dopamine agonists. In a fully developed case, a person may experience head nodding, pelvic rocking, and fine movements of the fingers and toes.