What is a drug-induced movement disorder?
The brain and muscles communicate with each other using chemical messengers called neurotransmitters. When this relay system works properly, the body is able to initiate and co-ordinate movements.
Some medications (drugs) interfere with the function of neurotransmitters and can lead to problems, resulting in an involuntary movement disorder. This may be because the dose of the drug is too high, or there is sensitivity to the drug.
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Drug-induced movement disorders include:
Tremors (shaking of a part of the body, often the arms or hands) – this occurs when opposing muscle groups contract in turn, producing a rhythmic movement that can’t be controlled.
Dystonia (abnormal twisting movements or distorted postures), resulting from a continuous involuntary muscle contraction. Dystonia may sometimes be painful and, can affect a single muscle, a group of muscles, or even larger parts of the body.
Parkinsonism – the symptoms of Parkinson’s disease can themselves be caused by certain medications. These include tremor, rigid limbs and slow movements.
Akathisia – this is a constant feeling of restlessness that leads to an uncontrollable urge to move a particular body part, often the legs.
Tics – these are repetitive jerky motions that often start in childhood and improve with age. They begin with an unpleasant urge to perform a certain movement, and the urge is relieved by the tic.
Tardive dyskinesia – this describes repetitive movements of the mouth, tongue, jaw and cheeks. It may lead to lip-smacking, sticking out the tongue, or puffing the cheeks.
What are the most common causes?
Any condition that affects the neurotransmitter known as dopamine is most often responsible. However, other neurotransmitters can also be involved. Older women are at the greatest risk of developing a drug-induced movement disorder, and the risk also increases with prolonged use of the drug.
Examples of drugs that affect neurotransmitter levels or function and cause movement disorders include:
Anti-psychotic drugs and some anti-sickness medications– these can affect dopamine activity in the brain, causing a variety of movement disorders.
Anti-epilepsy treatments and lithium therapy for the treatment of bipolar disorder (a mental health condition that is characterised by extreme mood swings) - these may lead to a tremor.
Anti-depressants– these have been shown to cause tremor or akathisia.
Treatments for Parkinson’s disease – although they aim to raise dopamine levels, they may in fact result in dystonia after a few months of treatment.
How is it diagnosed?
Our leading specialist doctors here at The London Clinic Centre for Movement Disorders will ask some questions about the symptoms and perform a careful physical assessment to determine the nature of the movement disorder. Information on the medications being taken will be of particular importance, as well as any other medical conditions.
The specialist may wish to carry out blood tests or perform MRI scans of the brain to rule out any other causes. Once a diagnosis has been made, our multidisciplinary team of professionals will be able to offer a comprehensive treatment plan.
How are they treated?
The most straightforward treatment for drug-induced movement disorders is to stop taking the drug responsible. Ideally, the drug should be switched to an alternative one that does not cause these symptoms. It is important that any drug changes are under the advice and guidance of a specialist.
Sometimes it may not be possible to stop the drug altogether, so reducing the dose may be enough to control the symptoms.
In cases of tardive dyskinesia and akathisia, where it is not possible to stop taking the drug, additional drugs can be started to control the movement disorder. These work by reducing the levels of dopamine in the brain.
Why choose The London Clinic?
At The London Clinic, we believe in offering first-class care. We can offer rapid access to leading specialists and physiotherapy experts who work within a highly-skilled multidisciplinary team. From diagnosis to treatment, we strive to ensure that each patient receives timely care without delay.