Which of the following extrapyramidal effect is seen on chronic use of antipsychotic -

Ans. is 'c' i.e., Tardive dyskinesia Neurological side effects of Neuroleptic DrugsReactionFeaturesTime of Maximal RiskProposed MechanismTreatmentAcute dystoniaSpasm of muscles of tongue, face, neck, back, may mimic sei- zures; not hysteria1 to 5 daysUnknownAntiparkinsonian ages are diagnostic and curativeAkathisiaMotor restlessness; not anxiety or "agitation"5 to 60 daysUnknownReduce dose or change drug; antiparkinsonian agents, benzodiazepines or propranolol may helpParkinsonismBradykinesia, rigidity, variable tremor, mask facies, shuffling gait5 to 30 days; can recur even after a single doseAntagonism of dopamineAntiparkinsonian agents helpfulNeuroleptic malignant syndromeCatatonia, stupor, fever unstable blood pressure myoglobinemia; can be fatalWeeks; can persist for days after stopping neuro- lepticAntagonism of dopamine may contri- buteStop neuroleptic immediately; dantrolene or bromocriptine may help; antiparkinsonism agents not effectivePerioral tremor "rabbit syndrome"Perioral tremor (may be a late variant of parkin- sonism)After months or years of treatmentUnknownAntiparkinsonian agents often helpTardive dyskinesiaOral-facial dyskinesia; widespread choreo- athetosis or dystoniaAfter months or years of treatment (worse on withdrawal)Excess function of dopamine hypothesizedPrevention crucial; treat- ment unsatisfactory