Medication-related movement effects and sedation

Covers akathisia, extrapyramidal effects, tremor, dystonia, tardive syndromes, and sedation.

Akathisia and EPSE cause marked distress and adherence breakdown and elevate suicide risk; acute dystonia can need faster intervention.

Safety snapshot

Urgent

Subjective inner restlessness is the key feature, often with observable motor restlessness.

3 of 6 diagnoses compared

CriteriaComparison detail	AkathisiaEmergency

3 of 6 comparedEdit

Urgent

Subjective inner restlessness is the key feature, often with observable motor restlessness.

+3 not selected

Open a selected differential to review its clinical record.

Based on current selection

Emergency

Clinical reference — not validated decision support. Review before use.

Why it fits	Inner restlessness, pacing, rocking, inability to sit still after antipsychotic or antidepressant exposure	Bradykinesia, rigidity, masked facies, resting tremor, reduced arm swing after antipsychotics or dopamine blockers	Oculogyric crisis, jaw spasm, torticollis, tongue spasm, opisthotonic posturing soon after dopamine blockade	Late repetitive oral-facial or choreiform movements after prolonged dopamine blockade	Fine postural bilateral tremor (lithium), coarse withdrawal tremor (alcohol), variable anxiety-related	Drowsiness, psychomotor slowing, reduced spontaneity, falls, aspiration risk after sedating drugs
What argues against	Applies to the whole presentationReview locally.
Must-not-miss	Suicidality, aggression, treatment refusal, severe distress	Falls, aspiration, severe functional decline	Airway compromise, severe distress, laryngospasm	Functional and social impairment, progressive worsening
Bedside question	Applies to the whole presentationSubjective inner restlessness is the key feature, often with observable motor restlessness.
Immediate action	Applies to the whole presentationOne of the most commonly missed and most distressing psychiatric side effects Bilateral onset after medication strongly suggests drug-induced parkinsonism
Investigations	Applies to the whole presentationThyroid function tests
Mimics / overlap	Applies to the whole presentationReview overlap locally.