Лікування гострих побічних ефектів антипсихотичних засобів
Symptoms | Treatment | Comments |
|---|---|---|
Acute dystonic reactions (eg, oculogyric crisis, torticollis) | Benztropine 2 mg IV or IM (may be repeated once in 20 minutes) Diphenhydramine 50 mg IV or IM every 20 minutes for 2 doses | Benztropine 2 mg orally may prevent dystonia when given with an antipsychotic. |
Laryngeal dystonia | Lorazepam 4 mg IV over 10 minutes, then 1–2 mg IV slowly | Intubation may be needed. |
Akinesia, severe parkinsonian tremors, bradykinesia | Benztropine 1–2 mg orally, IM or IV 2 to 3 times a day | In patients with akinesia, the antipsychotic may have to be stopped, and one with a lower potency used. |
Akathisia (with other extrapyramidal symptoms) | Amantadine 100–150 mg orally 2 times a day Benztropine 1–2 mg orally, IM or IV 2 to 3 times a day Biperiden 1–4 mg orally 2 times a day Procyclidine 2.5–10 mg orally 2 times a day Propranolol 10–30 mg orally 3 times a day Trihexyphenidyl 2–7 mg orally 2 times a day or 1–5 mg orally 3 times a day (or for the sustained-release form, 2–7 mg 2 times a day) | The causative antipsychotic should be stopped, or a lower dose used. |
Akathisia associated with extreme anxiety | Lorazepam 1 mg orally 3 times a day Clonazepam 0.5 mg orally 2 times a day | — |