Mental Disabilities Law Issues
| Publication year | 1981 |
| Pages | 788 |
| Citation | Vol. 10 No. 4 Pg. 788 |
1981, April, Pg. 788. Mental Disabilities Law Issues
In the early 1950s, medications which seemed to herald a new dawn in psychiatry first appeared on the U.S. market. Those medications are or have been known variously inter alia as tranquilizers, ataractics, psychoactives, psychotropics, neuroleptics and anti-psychotic drugs. Three major generic classes of medications are of concern here: phenothiazines (chief brand names are Thorazine, Mellaril, Prolixin and Stelazine); thioxanthenes (chief brand names are Taractan and Navane); and butyrophenones (chief brand name is Hal-dol). The use of such anti-psychotic medications has had a profound effect upon the psychiatric patient population, causing a marked reduction in electro- and insulin-shock usage, a signficant decrease in the number of psychiatric beds and hospitals and a corresponding increase in out-patient care.
Immediately after the introduction of these drugs, however, there began to be noticed a wide variety of side effects. These included parkinsonism (mask-like face, and rigidity and tremors of the hands and arms); dystonias (spasmodic muscle reactions, often with a twisting of the neck); akathesia (motor restlessness---the inability to sit still); and akanesia (physical immobility and lack of spontaneity). These symptoms were found to be reversible with withdrawal from or decrease in the dosage of the medications or when anti-parkinsonism drugs were administered.
Later, a new class of dyskinesic (abnormal or impaired movements) symptoms were noted. These included orofacial dyskinesia (twisting of the musculature of the mouth and face, including the tongue); chorea (spasmodic, uncoordinated movements of the limbs and facial muscles); athetosis (recurring involuntary, tentacle-like movements of the hands and feet); dystonia (abnormal muscular tone); tics and, in advanced cases, difficulty in breathing and swallowing. These symptoms were viewed as following from prolonged use of antipsychotic medications, particularly from use of the three general medication classes listed above. Often, the use of the anti-psychotic medication masked the symptoms, which then appeared when the individual was taken off the medication.
The syndrome of dyskinesia has been seen as essentially irreversible, appearing more among women than men and more frequently in women over the age of 50 years. Although the term "tardive" or late dys-kinesia was introduced in 1964,(fn1) the first reported appearance of the syndrome was in a 1959 article,(fn2) which attributed the first description to a 1952 report of what appeared to be a more benign class of parkinson-like symptoms.(fn3) However, in 1953, Labhardt reported symptoms which we now know as...
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