Movement disorders induced by dopamine blocking agents

Movement disorders are frequently due to dopamine blocking agents (DBAs) prescribed for psychiatric illnesses. DBAs are sometimes also prescribed inappropriately for other maladies. These drugs can cause a wide variety of involuntary movements, sometimes in combination. When these appear in the setting of psychiatric illnesses, the association is easy to recognize but the treatment remains a difficult problem. However, in other situations the diagnosis may be missed for extended periods of time, resulting in unnecessary diagnostic work-up and inappropriate therapy. The diagnosis depends on a compulsive drug history not only from the patient but also from patient's family, primary physician, and the pharmacist. The treatment options include removal of the offending agent or substitution with an atypical neuroleptic. Symptomatic treatments are varied and have an inconsistent effect on the movement disorders. Prevention remains the most important strategy.