Akathisia
| Akathisia | |
|---|---|
| File:Akathisie.ogv | |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Inner restlessness, inability to stay still |
| Complications | Anxiety, depression, suicide |
| Onset | Minutes to weeks after starting or increasing dose of antipsychotic medication |
| Duration | Variable, can persist for weeks to months |
| Types | N/A |
| Causes | Antipsychotic medications, SSRIs, other medications |
| Risks | High doses of antipsychotics, rapid dose escalation, history of akathisia |
| Diagnosis | Clinical evaluation |
| Differential diagnosis | Restless legs syndrome, tardive dyskinesia, anxiety disorder |
| Prevention | N/A |
| Treatment | Reducing or discontinuing the causative medication, beta blockers, benzodiazepines |
| Medication | Propranolol, lorazepam, mirtazapine |
| Prognosis | N/A |
| Frequency | Common in patients on antipsychotics |
| Deaths | N/A |
Akathisia is a movement disorder that manifests as a feeling of inner restlessness and the inability to stay still. It's a common side effect of certain medications, particularly antipsychotics.[1]
Clinical Presentation[edit]
Individuals with akathisia experience a compelling urge to move, often accompanied by uncomfortable sensations in the legs. This can manifest as rocking while standing or sitting, lifting the feet as if marching on the spot, crossing and uncrossing the legs, and pacing around.[2]
Causes[edit]
The most common cause of akathisia is medication, especially antipsychotic drugs. Other drugs, including certain antiemetics and antidepressants, can also cause akathisia. In some cases, akathisia can be a symptom of Parkinson's disease or a side effect of its treatment.
Diagnosis[edit]
Akathisia is usually diagnosed based on the patient's symptoms and history, especially the use of drugs associated with this condition. Various rating scales, such as the Barnes Akathisia Rating Scale (BARS), can be used to quantify the severity of symptoms.[3]
Management[edit]
Management strategies for akathisia include reducing the dose or discontinuing the offending drug, if possible. Other treatments include the use of drugs such as benzodiazepines, beta blockers, or anticholinergics to manage symptoms. In severe cases, hospitalization may be required.
Prognosis[edit]
With appropriate management, symptoms of akathisia can often be significantly reduced or eliminated. However, if left untreated, this condition can lead to distress, anxiety, and depression.[4]
Epidemiology[edit]
The incidence of akathisia varies significantly depending on the population studied and the specific medications used. It's particularly common among individuals receiving antipsychotic medication, with studies reporting incidences ranging from 20% to 75%.[5]
Research Directions[edit]
Despite significant advances in understanding the underlying mechanisms of akathisia, much remains unknown about this condition. Current research efforts are focused on identifying more effective treatment strategies and understanding the biological basis of drug-induced akathisia.
See Also[edit]
References[edit]
- ↑ Miller, CH."The spectrum of akathisia".Journal of Neuropsychiatry and Clinical Neurosciences.1994;6(1)
- 100-109.doi:10.1176/jnp.6.1.100.
- ↑ Barnes, TRE."A Rating Scale for Drug-Induced Akathisia".British Journal of Psychiatry.1989;154(5)
- 672-676.doi:10.1192/bjp.154.5.672.
- ↑ Sachdev, P."The development of the concept of akathisia: a historical overview".Schizophrenia Research.1995;14(2)
- 117-28.doi:10.1016/0920-9964(94)00056-4.
- ↑ Hansen, L."Extrapyramidal symptoms and signs in first-episode, drug-naive patients with schizophrenia".Acta Psychiatrica Scandinavica.2005;111(1)
- 67-73.doi:10.1111/j.1600-0447.2004.00423.x.
- ↑ Kane, JM."Tardive dyskinesia rates with atypical antipsychotics in adults: prevalence and incidence".Journal of Clinical Psychiatry.2001;62(Suppl 4)
- 21-31.
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| Diseases of the nervous system, primarily CNS (G04–G47, 323–349) | ||||||||||||||||||||
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