Pharmacological and Parenteral Therapies Q 19

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A patient at a mental health clinic is taking Haldol (haloperidol) for treatment of schizophrenia. She calls the clinic to report abnormal movements of her face and tongue. The nurse concludes that the patient is experiencing which of the following symptoms:

  

     A. Comorbid depression

     B. Psychotic hallucinations

     C. Negative symptoms of schizophrenia

     D. Tardive dyskinesia

    

    

Correct Answer: D. Tardive dyskinesia

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Abnormal facial movements and tongue protrusion in a patient taking haloperidol is most likely due to tardive dyskinesia, an adverse reaction to the antipsychotic. Tardive dyskinesia is a syndrome that includes a group of iatrogenic movement disorders caused by the blockade of dopamine receptors. The movement disorders include akathisia, dystonia, buccolingual stereotypy, myoclonus, chorea, tics and other abnormal involuntary movements which are commonly caused by the long-term use of typical antipsychotics.

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Option A: Depression and anxiety is frequently seen in many schizophrenic patients and may be further aggravated or diminished by antipsychotic treatments. Haloperidol is a conventional antipsychotic used in schizophrenia and psychosis.

Option B: Psychotic hallucinations may be visual or auditory but do not include abnormal movements. Hallucinations are most often associated with schizophrenia, a mental illness characterized by disordered thoughts and behaviors.

Option C: Depression may occur along with schizophrenia and would be characterized by such symptoms as loss of affect, appetite and/or sleep changes, and anhedonia. These depressive changes and lack of volition are part of the negative symptoms of schizophrenia.

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