Akathisia: A brief review

A critical review of akathisia

The Many Faces of Akathisia

Multidimensional Sensory Phenomena in Antipsychotic-Induced Akathisia

2000 Akathisia: Exacerbation of Pathology

Case of Akathisia

Patient Severe Zyprexa induced Acute Akathisia Withdrawl-Akathisia

Newton Wellesley Hospital, Newton, Ma. Dr. Jeri Walker  MD Gary Schultz R.N. pacing for >115 hours straight!!!

I. Acute Akathisia

 1. Causes of Acute Akathisia

Antiemetics

Typical Antipsychotics (Mellaril, Stelazine, High Potency Haldol, Thorazine, Trilafon)

Atypical Antipsychotics (Zyprexa, Risperdal, Geodon, Abilify, Seroquel)

Zyprexa Severe akathisia during olanzapine treatment of acute schizophrenia

Overview of Akathisia Rates in Atypicals and pharmacokinetics

Prevalence and characteristics of subjective akathisia, objective akathisia, and mixed akathisia in chronic schizophrenic subjects

2. Subjective experience of Acute Neuroleptic-Induced Akathisia(NIA)

Nov. 2002 abstract Subjective emotional experience and cognitive impairment in drug-induced akathisia

Nov. 2002 pdf Subjective emotional experience and cognitive impairment in drug-induced akathisia

3. Diagnosis of Acute Akathisia

Online Akathisia BAS Report Form

Barnes Akathisia Scale

Sachdev Akathisia Scale

An Electromyographic Marker for Neuroleptic Induced-Akathisia: Preliminary Measures of Sensitivity and Specificity

Clinical characteristics and predisposing factors in acute Drug-Induced Akathisia

Clinical correlates of akathisia in acute psychiatric inpatients

2003 Dr. TR Barnes The Barnes Akathisia Rating Scale--revisited

2005 Actometry and Barnes Akathisia Rating Scale in neuroleptic-induced akathisia

2005 full-text Actometry and Barnes Akathisia Rating Scale in neuroleptic-induced akathisia

actometry table

Case studies of review of diagnosis and treatment of acute drug-induced akathisia

4. Diagnostic Challenges of Acute Akathisia

        The Causes of Underdiagnosing Akathisia Japan

5. Acute Akathisia Treatment

Effect of Intravenous Biperiden on Severe Acute Akathisia

2000 Japan Intravenous biperiden in akathisia: an open pilot study

2000 Japan pdf of Previous abstract

 

Effect of Intravenous Diazepam (Valium) on Severe Acute Akathisia

1973 The therapeutic use of diazepam for akathisia

1978 Intravenous diazepam in the treatment of neuroleptic-induced acute dystonia and akathisia

1983 Diazepam in the treatment of extra pyramidal symptoms: a case report

June 2002 Immediate effect of intravenous diazepam in neuroleptic-induced acute akathisia: an open-label study

 June 2002 pdf of previous abstract

 

other clinical studies

1990 The Pharmacological Treatment of Neuroleptic Induced Akathisia

1991 A placebo-controlled trial of nadolol in the Treatment of Neuroleptic-Induced Akathisia

1997 Serotenergic Agents in the treatment of acute Neuroleptic-Induced Akathisia

1997 Treatment of Neuroleptic Induced Akathisia with Nicotine Patches

Jan. 2000 Japan Intravenous administration of levodopa ameliorated a refractory akathisia case induced by interferon-alpha  

April, 2002 Israel Efficacy of Low-Dose Mirtazapine in Neuroleptic-Induced Akathisia: A Double-Blind Randomized Placebo-Controlled Pilot Study

2001 Diphenhydramine for the prevention of akathisia induced by Prochlorperazine A Randomized, Controlled Study

2003 Treatment of Neurolepti-Induced Akathisia with the 5HT2a Trazadone

March 2004 Diphenhydramine in the treatment of akathisia induced by prochlorperazine

March 2004 Diphenhydramine in the treatment of akathisia induced by prochlorperazine
Table 1 | Table 2 | Table 3

October, 2004 Central action beta-blockers versus placebo for neuroleptic-induced acute akathisia

2004 Anticholinergics for neuroleptic-induced acute akathisia

November, 2004 Vitamin B6 treatment in acute neuroleptic-induced akathisia: a randomized, double-blind, placebo-controlled study

 May, 2005 Quebec Gabapentin in the treatment of antipsychotic-induced akathisia in schizophrenia
 

II. Chronic/Tardive Akathisia

1. Diagnosis of Chronic/Tardive Akathisia

Restlessness, shuffling of legs, moving from chair to chair. Less subjective inner restlessness and generally no subjective restlessness.

Neuroleptic-Induced Acute and Chronic Akathisia: A Clinical Comparison

2. Causes Chronic/Tardive Akathisia

All Conventional Antipsychotics high risk. Atypical Antipsychotics variable low risk. Risperdal, Abilify, Geodon, Zyprexa, Seroquel Clozaril risk from high-low to low-low(0) risk. Requires at least 3months for a tardive diagnosis, may occur 1, 2, 5 years afterwards.

3. Treatment of Chrnoic/Tardive Akathisia

Tardive akathisia: an analysis of clinical features and response to open therapeutic trials

Jul. 1997 Clozapine treatment for neuroleptic-induced tardive dyskinesia, parkinsonism, and chronic akathisia in schizophrenic patients

Jul. 1997 Clozapine treatment for neuroleptic-induced tardive dyskinesia, parkinsonism, and chronic akathisia in schizophrenic patients

III. Withdrawl Akathisia
 

Dec. 1987 Antipsychotic-Withdrawl akathisia versus antipsychotic induced akathisia: further evidence for the existence of tardive akathisia

Severe withdrawal akathisia following neuroleptic discontinuation successfully controlled by clozapine

 

IV. Suicide and Akathisia and Prozac

        1992 Akathisia, Suicidality, Fluoxetine

                Fluoxetine, Suicidality, Akathisia: Is there a causal connection

        1994 Revisiting Fluoxetine (Prozac) and Suicidal Occupations

V. Suicide and Akathisia

 The Relationship of Akathisia with depersonalization and suicidality among patients with schizophrenia

A Case Controlled Study of 92 Inpatient Suicides

 Drug induced akathisia, suicidal ideation and its treatment in the elderly

Drug-induced akathisia and suicidal tendencies in psychotic patients

Suicide attempts associated with akathisia

V. Corporate interest in Akathisia

ACP-103 in the treatment of akathisia   Acadia Pharmaceuticals