Extrapyramidal Symptoms

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• Extrapyramidal Symptoms
•       Dystonia severe muscle spasm
•       Akathisia inner motor restlessness
•       Pseudoparkinsonism
•     Decreased motor activity
•     Slowed speech
•     Decreased arm swing
• Pill-rolling tremor
• Cog-wheel rigidity

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Tardive Dyskinesia Orofacial movements Forward
and lateral movements of tongue Movement in
extremities and truncal areas
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Client receiving Mellaril 300 mg daily for gt 5
yrs Interdisciplinary team met annualldecided
against dose reduction Mellaril 300 mg daily
maintenance dose based on     Zero episodes of
psychotic symptoms     Maintained successful
residential placement in community     Hold down
a job
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• Regulation 483.440(f)(3)
• The facility must designate and use a specially
  constituted committee. To
• (i) review, approve, and monitor individual
  programs designed to manage
• Inappropriate behavior and other programs that,
  in the opinion of the
• committee, involve risks to client protection and
  rights
• (ii) Insure that these programs are conducted
  only with the written informed
• Consent of the client, parents (if the client is
  a minor) or legal guardian

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