Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-24T06:17:40.164Z Has data issue: false hasContentIssue false

Finger Tremor and Extrapyramidal Side Effects of Neuroleptic Drugs

Published online by Cambridge University Press:  29 January 2018

Paul Collins
Affiliation:
University Department of Psychiatry, Royal South Hants Hospital, Graham Road, Southampton
Ian Lee
Affiliation:
University Department of Psychiatry, Royal South Hants Hospital, Graham Road, Southampton
Peter Tyrer
Affiliation:
University Department of Psychiatry, Royal South Hants Hospital, Graham Road, Southampton

Summary

Finger tremor and extrapyramidal side-effects (EPSEs) were measured in seven patients before and during neuroleptic drug treatment to assess the relationship between the onset of EPSEs and changes in finger tremor spectra. Tremor and EPSEs were also measured in twelve patients stabilized on neuroleptic drugs to determine whether tremor could provide a reliable index of the presence and severity of extrapyramidal system disturbance. A downward shift in peak tremor frequency was noted within 48 hours of starting neuroleptic drug therapy, usually before the onset of EPSEs, and a significant negative relationship between the severity of EPSEs and tremor frequency (but not tremor amplitude). The peak frequency of finger tremor is thus a sensitive index of extrapyramidal disturbance and might be of value in predicting which patients taking neuroleptic drugs need anti-parkinsonian therapy.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1979 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Blackman, R. B. & Tukey, J. W. (1959) The Measurement of Power Spectra. New York: Dover Publications.Google Scholar
Carrie, J. R. G. (1965) Finger tremor in alcoholic patients. Journal of Neurology, Neurosurgery and Psychiatry, 28, 529–32.Google Scholar
Coleman, J. H. & Hayes, P. E. (1975) Drug induced extrapyramidal effects—a review. Diseases of the Nervous System, 36, 591–3.Google ScholarPubMed
Dimascio, A. & Demergian, E. (1970) Antiparkinson drug overuse. Psychosomatics, 11, 596601.Google Scholar
Eagles, J. B., Halliday, A. M. & Redfearn, J. W. T. (1953) The effects of fatigue on tremor. In Symposium on Fatigue (eds. Floyd and Welford). London: Lewis.Google Scholar
Graham, J. D. P. (1945) Static tremor in anxiety states. Journal of Neurology, Neurosurgery and Psychiatry, 8, 5760.Google Scholar
Lader, M. H. (1970) Drug induced extrapyramidal syndromes. Journal of the Royal College of Physicians of London, 5, 8798.Google Scholar
Marsden, C. D., Foley, T. H., Owen, D. A. L. & McAllister, R. G. (1967) Peripheral β-adrenergic receptors concerned with tremor. Clinical Sciences, 33, 5365.Google Scholar
Marsden, C. D., Gimlette, T. M. D., McAllister, R. G., Owen, D. A. L. & Miller, T. N. (1968) The effects of beta adrenergic blockade on finger tremor and achilles reflex time in anxious and thyrotoxic patients. Acta Endocrinologica (Kbh), 57, 353–62.Google Scholar
Marsden, C. D., Meadows, J. C., Lange, G. W. & Watson, R. S. (1969) Variation in human physiological finger tremor with particular reference to changes with age. Electroencephalography and Clinical Neurophysiology, 27, 169–78.Google Scholar
Marsden, C. D., Meadows, J. C., Lange, G. W. (1970) Effect of muscle contraction on physiological tremor in normal subjects and in patients with thyrotoxicosis and myxoedema. Journal of Neurology, Neurosurgery and Psychiatry, 33, 776–82.Google Scholar
Marshall, J. & Walsh, E. G. (1956) Physiological tremor. Journal of Neurology, Neurosurgery and Psychiatry, 19, 260–7.CrossRefGoogle ScholarPubMed
Mindham, R. H. S., Gaind, R., Anstee, B. H. & Rimmer, L. (1972) Comparison of amantadine, orphenadrine and placebo in the control of phenothiazine induced parkinsonism. Psychological Medicine, 2, 406–13.CrossRefGoogle ScholarPubMed
Mindham, R. H. S. (1976) Assessment of drug-induced extrapyramidal reactions and of drugs given for their control. British Journal of Clinical Pharmacology, Supplement, 395400.CrossRefGoogle Scholar
Mindham, R. H. S., Lamb, P. & Bradley, R. (1977) A comparison of piribedil, procyclidine and placebo in the control of phenothiazine induced parkinsonism. British Journal of Psychiatry, 130, 581–5.Google Scholar
Randall, J. E. & Metzger, J. M. (1963) Variance as a measure of tremor amplitude. Journal of Applied Physiology, 18, 440–1.CrossRefGoogle ScholarPubMed
Redfearn, J. W. T. (1957) Frequency analysis of physiological and neurotic tremors. Journal of Neurology, Neurosurgery and Psychiatry, 20, 302–13.Google Scholar
Schäfer, E. A., Canney, H. E. L. & Tunstall, J. O. (1886) On the rhythm of muscular response to volitional impulses in man. Journal of Physiology, 7, 111–17.CrossRefGoogle ScholarPubMed
Simpson, G. M. & Angus;, J. W. S. (1970) Drug induced extrapyramidal disorders—a rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica Supplement 212, 1119.CrossRefGoogle Scholar
Sutton, G. G. & Sykes, K. (1967) The variation of hand tremor with force in healthy subjects. Journal of Physiology, 191, 699711.CrossRefGoogle ScholarPubMed
Swett, C., Cole, J. P., Shapiro, S. & Slone, D. (1977) Extrapyramidal side effects in chlorpromazine recipients—emergence according to benztropine prophylaxis. Archives of General Psychiatry, 34, 942–3.Google Scholar
Tyrer, P. J. & Bond, A. J. (1974) Diurnal variation in physiological tremor. Electroencephalography and Clinical Neurophysiology, 37, 3540.CrossRefGoogle ScholarPubMed
Tyrer, P. J. & Lader, M. H. (1974) Tremor in acute and chronic anxiety. Archives of General Psychiatry, 31, 506–9.Google Scholar
Tyrer, P. J. & Kasriel, J. (1975) Genetical components of physiological tremor. Journal of Medical Genetics, 12, 162–4.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.