What is acute dystonia?

Acute dystonia, also known as acute dystonic reaction, is a condition that causes involuntary muscle spasms and a bent or twisted posture. It is usually a side effect of antipsychotic medications that are used in the treatment of several different psychiatric disorders, such as schizophrenia and the mania associated with bipolar disorder. Acute dystonia is thought to be caused by agents in the medication that block the release of dopamine in the brain.

Primary dystonia is a neurological disorder in which a person experiences constant muscle spasms. It is believed to be caused by faulty signals from the brain to the muscles. Primary dystonia is genetic and there is no cure. An acute dystonic reaction is a temporary and curable version of the disorder and is caused by specific drug use.

The main symptoms of acute dystonia are sudden muscle spasms of the face, neck, back, and extremities after taking antipsychotic medications. It can also cause pain in the neck, jaw, and tongue. In rare cases, a person may have slurred speech, abnormal eye twitching, or difficulty seeing.

Antipsychotic medications, such as clozapine, risperidone, olanzapine, quetiapine, and ziprasidone, control the symptoms of psychotic disorders but cannot cure them. The drug works by blocking dopamine, a neurotransmitter in the brain that sends signals to nerve cells. Dopamine blockade can reduce visual and auditory hallucinations and paranoia. Dopamine-blocking agents can interfere with the ability of nerve cells to properly receive signals from the brain and can cause muscle spasms; However, there is no conclusive evidence as to why this happens. Acute dystonia tends to occur when the level of antipsychotic medication in the bloodstream begins to drop, rather than when it is at higher levels in the blood.

Antiemetic medication, such as metoclopramide, droperidol, and domperidone, can also cause acute dystonia in rare cases. The drug is usually used to treat motion sickness or nausea. Some varieties of medication can use dopamine-blocking agents to reduce feelings of nausea; however, the condition tends to be more commonly associated with antipsychotic medications.

Acute dystonia can be treated with anticholinergic medications. These medications block acetylcholine, a neurotransmitter responsible for regulating the muscular system. It is usually taken for a day or two after the reaction occurs. The antipsychotic medication that contributed to the reaction may be discontinued or changed to a lower potency.

Men taking antipsychotic medications are thought to be more likely than women to have an acute dystonic reaction. The reaction is thought to be genetic, so those with a family history are more likely to experience it. Cocaine use and liver dysfunction can also increase the likelihood of dystonia.

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