ANTIPSYCHOTIC DRUGS

Brief History. R.F., a 63-year-old woman, has been receiving treatment for schizophrenia intermittently for many years. She was last hospitalized for an acute episode 7 months ago and has since been on a maintenance dosage of haloperidol (Haldol), 25 mg/d. She is also being seen as an outpatient for treatment of rheumatoid arthritis in both hands. Her current treatment consists of gentle heat and active range-of-motion exercises, three times each week. She is being considered for possible metacarpophalangeal joint replacement. Problem/Infl uence of Medication. During the course of physical therapy, the therapist noticed the onset and slow, progressive increase in writhing gestures of both upper extremities. Extraneous movements of her mouth and face were also observed, including chewing-like jaw movements and tongue protrusion.

1. Why might antipsychotic drugs cause these abnormal movements?

2. What specifi c movement disorder might be indicated by these symptoms? 3. Why is it critical to resolve this situation as soon as possible?