DrVirgo
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Neuroleptics (decrease dopamine) and cause Tardive Dyskinesias (tongue protrusion, tremors and spasms of body).
In Kaplan Behav. its written "Anti-Parkinson drugs aggravate TD"
I was wondering why this is because Anti-Parkinson drugs increase dopamine, whereas Neuroleptics decrease dopamine, so how can they both be responsible for the same side effects?
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| DrVirgo
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Nevermind. Got it.
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| ed222
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In BRS pharm says it is a supersensitivity of the postjunctional dopamine receptors in the basal ganglia. But the condition itself is predisposed by the prophylactic use of anticholinergic drugs. The only and only treatment is discontinuation of the treatment. Then lateer change for a different drug like clozapine. Antiparkinsonian drugs don't help, remember there is a hypersensitivity in the basal ganglia.
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| DrVirgo
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thanks ed... I figured it out a while ago as well... here's what i know now: 
-Normally the inhibitory effects of dopaminergic neurons is normally balanced by excitatory actions of cholinergic neurons.
Tardive Dyskinesia:
-TD's result from long-term treatment of Neuroleptic therapy. What happens is that an INCREASED number of dopamine receptors are synthesized in response to the long-term dopamine receptor blockade. This makes the neuron supersensitive to the actions of dopamine and allows the dopaminergic input to this structure to overpower the cholinergic input, causing excess movement in the patient.
Parkinsons: Decrease Dopamine and Increased Ach.
Parkinsons Drugs: Increase Dopamine, Decrease Ach (therefore they can also cause TD's)
Extrapyramydal Symptoms
-EPS are:
1 Week: Dysontia (jerky movements, trouble speaking)
2 Weeks: Akinesia (no movement
3 Weeks: Rigidity (robot like)
6 Weeks: Tremors (of the head, hands, arms, etc)
10 Weeks: Akathesia (vibrating feeling, can't sit still)
18+ Weeks: Pisa and Rabbit
EPS
-Due to blocking dopamine, which alters the Dopamine/Ach balance, causing an EXCESS of Cholinergic influence and resulting in EPS.
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