Table 2 Frequently used drugs in the intensive care unit associated with abnormal movements listed in alphabetical order
From: Abnormal movements in critical care patients with brain injury: a diagnostic approach
Drug class | Abnormal movement type with specific drug if applicable |
|---|---|
Analgesics | Seizures (meperidine and tramadol) Clonus and myoclonus in the setting of serotonin syndrome (tramadol) |
Antibiotics | Myoclonus and seizures with cefalosporins in renal failure Seizures (fluoroquinolones and carbapenems) Tremor (amphotericine) Clonus in the setting of serotonin syndrome (linezolid) |
Antidepressants and mood stabilizers | Seizures (SSRI, TCA and bupropione) Tremor (lithium) Chorea (lithium) |
Antiepileptics | Tremor (valproic acid) Ataxia and nystagmus (phenytoin) Seizures may be seen with toxic doses (phenytoin) Chorea (phenytoin, carbamazepine, valproic acid) |
Antipsychotics | Seizures with almost all of them (especially clozapine) Acute dystonic reaction affecting mainly the cervical, cranial and axial muscles seen most commonly with typical neuroleptics such as haloperidol Neuroleptic malignant syndrome Akasthesia Tardive dyskinesia as a long-term effect Tremor |
Cardiovascular agents | Seizures (digoxin toxicity) Tremor (amiodarone, procainamide) |
Contrast agents | Seizures (diatrizoic acid) |
Hormones | Tremor (levothyroxine, epinephrine) Chorea (levothyroxine) |
Gastrointestinal agents | Acute dystonic reaction (metoclopramide) Neuroleptic malignant syndrome (metoclopramide) Tardive dyskinesia as a long-term effect (metoclopramide) Tremor (metoclopramide, cimetidine) Chorea (metoclopramide) |
Misused drugs | Seizures (alcohol withdrawal, cocaine and amphetamine toxicity) Tremor (same drugs that cause seizures) Chorea (amphetamine, cocaine) |