Extrapyramidal reactions such as an acute spasm of the mandible caused by first-generation antipsychotics such as phenothiazines

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Alternatives may include decreasing the dose of the patient's medication,adding an anticholinergic medication to counteract the spasm,or changing the patient's antipsychotic medication to one that produces fewer extrapyramidal effects.The anticholinergics used to counteract the extrapyramidal side effects of the antipsychotics include benzotropine (Cogentin)and trihexyphenidyl (Artane).The severity and prevalence of extrapyramidal reactions depends on the balance between acetylcholine and dopamine.Too much dopamine blockade will lead to these side effects.An anticholinergic can partially restore the balance between dopamine and acetylcholine action in specific brain regions associated with muscle control,such as the corpus striatum.Akathisia is an extrapyramidal reaction characterized by increased compulsive motor activity.

Extrapyramidal Reactions Such as an Acute Spasm of the Mandible