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Akathisia: Problem of History or Concern of Today

Published online by Cambridge University Press:  07 November 2014

Naveed Iqbal
Affiliation:
Dr. Iqbal is associate professor of clinical psychiatry at, Albert Einstein College of Medicinein Bronx, New York, and director of research at Advanced Bio-Behavioral Sciences in Elmsford, New York
Tim Lambert
Affiliation:
Dr. Lambert is professor of psychological medicine at the, University of Sydneyand Head of Schizophrenia Treatments and Outcomes Research at the Brain and Mind Research Institute, Sydney
Prakash Masand
Affiliation:
Dr. Masand is consulting professor of psychiatry at, Duke UniversityMedical Center in Durham, North Carolina

Abstract

Akathisia is a neurological side effect of antipsychotic medications, which are used to treat various psychiatric disorders. Akathisia is characterized by physical restlessness and a subjective urge to move. Although side effects such as akathisia, dystonia, and dyskinesia are common with the use of conventional antipsychotics, they occur in reduced frequency with the use of new-generation antipsychotics. Despite a lowered incidence profile, akathisia and similar conditions continue to affect patients. Neuroleptic-induced akathisia can present as fidgety movements while seated, rocking in place while standing, pacing, inability to sit or stand still for an extended period of time, and an overwhelming urge to move. These symptoms can cause severe distress and an increased risk of suicide for affected patients. First-line treatment of akathisia includes benzodiazepines or β-blockers for patients who do not have symptoms of Parkinson's disease and anticholinergic medications for patients with Parkinson's symptoms. Clinicians should ensure that an accurate diagnosis of akathisia is made and that target symptoms are decreasing due to treatment. At the same time, it must be ensured that the treatment used does not negatively affect the mental health of the patient. This expert roundtable supplement will address the diagnosis, pathophysiology, phenomenology, classification, and history of akathisia as well as discuss screening tools and treatment options for the condition.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2007

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