What are extrapyramidal symptoms (EPS) and name two examples.

• A. Sleep disturbances; examples include insomnia and somnolence
• B. Cognitive disturbances; examples include amnesia and aphasia
• C. Mood changes; examples include euphoria and apathy
• D. Drug-induced movement disorders; examples include dystonia and akathisia

Answer: (D)

Extrapyramidal symptoms are movement disorders caused by medications that block dopamine in the brain’s extrapyramidal motor pathways, most commonly antipsychotics. This dopamine blockade in the nigrostriatal pathway leads to motor symptoms rather than changes in mood, thinking, or sleep. Two typical examples are dystonia, which features sudden, sometimes painful muscle contractions causing abnormal postures (often of the neck, face, or tongue), and akathisia, a subjective sense of inner restlessness with an urge to move, resulting in pacing or inability to sit still. Other related EPS include parkinsonism (tremor, rigidity, slowed movements) and tardive dyskinesia (late-onset, repetitive involuntary movements). The other described categories—sleep disturbances, cognitive disturbances, or mood changes—do not reflect these drug-induced movement disorders.