In the following case report we present a 43-year-old male patient diagnosed with
schizophrenia, paranoid type, who exhibited nocturnal
tardive akathisia or pseydoakathisia approximately one year after being treated with
clozapine 300 mg per day. Because of the low occurrence of
akathisia due to
clozapine, the episodes of
restlessness were at first considered as a sign of worsening of the patient's psychopathology. Since the patient was resistant to other
antipsychotic agents,
clozapine was reinitiated. A week later, the patient once again exhibited episodes of
restlessness. This time, the episodes were diagnosed as
akathisia and the patient was treated with
biperidene and
lorazepam, while he had already been on
propanolol for cardiovascular reasons. The episodes continued without any change in frequency or severity. Therefore, treatment with
clozapine was discontinued and the patient was started on a new regimen with
ziprasidone. Three days later, the episodes that caused distress to the patient resolved. Thus, it is possible that apart from episodes of acute
akathisia, episodes of
tardive akathisia or pseydoakathisia can also occur in patients treated with atypical
antipsychotics.