EPS . . .

I was asked after the last post about EPS. EPS is extrapyramidal symptoms. It is a reaction to anti-psychotic medication. The first medication Dustin had a reaction to was trileptal. He broke out in a massive rash. He was fine in the morning when we sent him to school and within an hour or arriving he was covered in a rash from head to toe. The nurse said you could actually watch it grow. It was freaky. This was after about a week on the medication. It is unclear as to whether the reaction would've gotten worse and developed into EPS. We gave him Benadryl immediately and for about 5 days after and he never took it again.

The next reaction was to Trazadone. After he had been taking it about 4 weeks he began to have problems with him bottom jaw. I thought it was simply a tic and had become a habit. Within a few days he was slobbery and talking funny. He complained of a sore throat and he talked like he had strep throat. A cough started so we gave cough medicine. That Thursday at school (he was attending an alternative school on the campus where his former psychiatrist was) they called the psychiatrist over to the school because he was complaining of his neck hurting. At this time NO ONE told me this was a group of dangerous side effects called EPS. They just said he was having a reaction. The doc gave him Cogentin and said it would get better.

By Friday he was a bit better physically but he was very paranoid and very distracted. He kept looking up to the place where the ceiling meets the wall. He was not sleeping. The p-doc visited with him at school again and upped the Cogentin, still leaving him on the Trazadone.

By Saturday morning we were in deep. His neck was so wore he could not move his head downward. He was constantly looking up. He was displaying Dyskinesias, Akathisia and Dystonia.

Dyskinesias are movement disorders and can include any of a number of repetitive, involuntary, and purposeless body or facial movements like :

• Tongue movements, such as "tongue thrusts" or "fly-catching" movements
• Lip smacking
• Finger movements
• Eye blinking
• Movements of the arms or legs
  

He was doing ALL of these. He had no idea he was doing them. He was clueless. You could tell him to stop and he would just say what and keep doing it.

Akathisia is an extreme form of internal or external restlessness. It may be a complete inability to sit still, with an urge to be moving constantly. I think this was why he was unable to sleep. I have been told that this can lead to suicide because it is so unbearable.

Dystonia is a muscle tension disorder involving very strong muscle contractions. These uncontrollable muscle contractions can cause unusual twisting of parts of the body, especially the neck. The condition can be extremely painful and can affect any part of the body, including the eyes. He would be totally okay then he would look like he was having a seizure. He would just start jerking his shoulder or his leg or his arm. It was frightening.

It was so bad, my mom came and took him to her house so we could have a break. While there he started have awful hallucinations. He was saying that "they" were coming from the ceiling. By about 9:00 at night he was screaming and running saying that the demons were coming to get him. He was pointing and screaming. At this point he had not slept in about 56 hours. My mom called scared. I came over and we took him to the ER. They admitted him and we removed him from the Trazadone. It took 3 days in the hospital and lots of shots of Geodon to dope him up while his body recovered.

He has had a few other instances of this reaction. The first time he had the reaction I called our current psychiatrist (who was new to us at the time) and told him that we had this happen before. He called it EPS and had me immediately remove him from the med. He told me that if we ignored the reaction it could be very dangerous. One time it happened in the psych hospital and I noticed it while visiting. Two other times we had recently had a dosage increase and reverting to the old dosage worked to stop the EPS. He has a very touchy system and dosage increases have to be done very small. I am thankful that our psychiatrist understands this and is super careful.

Scary stuff.