Medical mnemonic for movement disorder antipsychotic medications side effects onset.
The rule of 4′s:
Dystonia(acute): 4 hours(up to 4 days)
AkiNesia: at 4 days
AkaThesia: at 4 weeks (according to some sources Akathesia can occur at any time)
Tardive Dyskinesia: 4 months (greater than)
· Note that tardive is obviously the latest one to happen (tardive=tardy/late).
The first one starts with DysTonia, and the last one is TD . AkiNesia and AkaThesia are in the middle. Which one comes first? N is before T in the alphabet;hence, Akinesia is before Akathisia in the mnemonic DAAT.
Some more medterms to make it clear:
Dystonia(an involuntary muscle contraction that causes sustained twisted or abnormal posturing):dys- abnormal and ton- (tone) – normal state of tension or relaxation of muscles
Akinesia: a- without, lacking and kinesia – movement
Akathesia(body restlessness):a- without, lacking and kathisia – to sit
kinesia – movement
Tardive(means tardy/late) Dyskinesia(lack of ability to control movements, characterized by spasmodic or repetitive movements or lack of coordination):dys- abnormal and kinesia – movement.
Note: Dyskinesia refers to involuntary movements, similar to a tic or chorea. Dyskinesia is a symptom of several medical disorders and is distinguished by the underlying cause.
When a dyskinesia presents after treatment with an antipsychotic drug such as haloperidol, it is a tardive dyskinesia and is commonly found in face as tongue “rolling”. A dyskinesia found in a patient with Parkinson’s disease is more commonly a jerky, dance-like movement of the arms or head and usually presents after several years of treatment with medication containing L-dopa.
