What is a common adverse effect of antipsychotics such as haloperidol, and what nursing consideration follows?

• A. Sedation and weight gain are the only concerns; monitor lipids.
• B. Extrapyramidal symptoms; monitor for dystonia, akathisia, and provide anticholinergic as needed.
• C. There are no movement disorders with typical antipsychotics.
• D. They cause hyperactivity and increased appetite but no EPS.

Answer: (B)

Antipsychotics like haloperidol commonly cause extrapyramidal symptoms because strong dopamine D2 blockade in the nigrostriatal pathway disrupts normal motor control. The key nursing focus is monitoring for these movement disorders—dystonia (muscle contractions, twisting, grimacing), akathisia (restlessness), and parkinsonian symptoms (rigidity, tremor). If EPS appears, administer an anticholinergic such as benztropine or diphenhydramine as ordered and reassess the medication plan (dose adjustment or changing to a drug with less EPS risk if needed). Educate the patient about signs to report and recognize that while sedation and weight gain can occur, EPS is the primary movement-related concern with haloperidol, especially with long-term use where tardive dyskinesia risk also becomes important.