A patient receiving thioridazine (Mellaril) for the last 3 weeks ...

[bobbie]

A patient receiving thioridazine (Mellaril) for the last 3 weeks is noted to have a mask-like ex-pression and to walk with a shuffling gait. What is an accurate interpretation of this patient's be-havior?
 
  a. Dystonia
  b. Parkinsonism
  c. Akathisia
  d. Tardive dyskinesia

Question 2

A patient was started on antipsychotic therapy with fluphenazine (Prolixin) a week ago. During a follow-up visit, the patient states an inability to sit still and is observed to be restless and fidget-ing in the chair.x
 
  What is an accurate interpretation of this patient's behavior?
  a. Dystonia
  b. Parkinsonism
  c. Akathisia
  d. Tardive dyskinesia

[Brenm]

Answer to Question 1

ANS: B
Parkinsonism is an extrapyramidal side effect of antipsychotic therapy with drugs such as thiori-dazine. The patient presentation closely resembles that of a patient with actual Parkinson's dis-ease. Bradykinesia, mask-like facies, drooling, tremor, cogwheel rigidity, and shuffling gait may be noted.

Answer to Question 2

ANS: C
Akathisia is an extrapyramidal symptom that is one of the adverse effects of antipsychotic drug therapy. It is best described as a subjective experience of restlessness, which can lead to muscle quivering, and restless movements and behavior. It generally occurs within the first 2 weeks of treatment. It affects all age groups, but affects women twice as frequently as men.