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Psychomotor Agitation (Akathisia)

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A feeling of restlessness associated with increased motor activity. This may occur as a manifestation of nervous system drug toxicity or other conditions.

Also Known As:

Akathisia; Restlessness; Psychomotor Hyperactivity; Psychomotor Restlessness; Hyperactivity, Psychomotor; Psychomotor Excitement; Restlessness, Psychomotor; Agitation, Psychomotor; Excitement, Psychomotor

Networked: 1632 relevant articles (144 outcomes, 155 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Parkinsonian Disorders (Parkinsonism)
2.	Schizophrenia (Dementia Praecox)
3.	Tremor (Tremors)
4.	Nausea
5.	Pain (Aches)

Experts

1.	Citrome, Leslie: 20 articles (01/2015 - 12/2002)
2.	Weizman, Abraham: 13 articles (12/2015 - 05/2003)
3.	Kane, John M: 11 articles (11/2015 - 08/2003)
4.	Calabrese, Joseph R: 9 articles (10/2015 - 04/2006)
5.	Carson, William H: 8 articles (02/2012 - 04/2006)
6.	Marcus, Ronald N: 8 articles (01/2009 - 04/2006)
7.	McQuade, Robert D: 8 articles (10/2008 - 06/2003)
8.	Poyurovsky, Michael: 7 articles (12/2015 - 05/2003)
9.	Leucht, Stefan: 7 articles (01/2015 - 01/2009)
10.	Kim, Jong-Hoon: 7 articles (01/2013 - 11/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Psychomotor Agitation:

1.	Propranolol (Inderal)FDA LinkGeneric 01/01/2000 - "Based on the available literature, propranolol or other lipophilic beta-blockers seem to be the most consistently effective treatment for acute akathisia. " 08/01/1993 - "Propranolol failed to produce a significant improvement overall in any of the akathisia measures, with only one patient showing clinical improvement. " 02/01/1991 - "Eight patients were subsequently treated in a nonblind manner with racemic propranolol, with a significant reduction in akathisia scores. " 01/01/1988 - "Neither propranolol nor placebo treated patients showed a significant improvement in akathisia. " 01/01/1989 - "This study shows that 120 mg of propranolol a day is more effective than placebo in reducing akathisia, and that propranolol's antiakathisic effect may require several days of treatment."
2.	Antipsychotic Agents (Antipsychotics)IBA 06/01/2015 - "The main symptomatic manifestations of this circuit abnormality are psychomotor agitation and stereotypical behaviors, which are relieved by antipsychotics. " 06/01/2013 - "Are low doses of antipsychotics effective in the management of psychomotor agitation? " 04/01/2013 - "The aim of this study was to identify whether the A1(T) allele of DRD2/ANKK1 was associated with akathisia (as measured by Barnes Akathisia Rating Scale) in a clinical sample of 234 patients who were treated with antipsychotic drugs. " 05/01/2009 - "Recent studies using large databases clearly indicate that extrapyramidal side effects, in particular akathisia, do occur with the SGAs, although the frequency is not as high as with the conventional antipsychotics. " 10/01/2008 - "Based on preliminary studies with antipsychotic drugs, a subgroup of patients who experience akathisia may be particularly vulnerable to suicide. "
3.	olanzapine (Zyprexa)FDA Link 02/15/1999 - "Olanzapine demonstrated significantly greater mean improvement from baseline in Positive and Negative Syndrome Scale (PANSS) negative symptoms, comorbid depressive symptoms assessed by the Montgomery-Asberg Depression Rating Scale, akathisia as measured by Barnes Akathisia Scale, and extrapyramidal symptoms as measured by Simpson-Angus Extrapyramidal Rating Scale with both LOCF and completers analyses. " 04/01/2012 - "A case of akathisia after switching from branded to generic high-dose olanzapine." 08/01/2009 - "Paired comparisons did not show the hypothesized pattern of relationships for akathisia or EPS, but such a pattern was suggested for olanzapine in the analysis of weight although it emerged at 2, 3 and 4 capsules indicating a general drug effect rather than a relative dosing difference. " 12/01/2006 - "In our case study we describe the appearance of akathisia next to olanzapine therapy in the case of a 65 years old woman, and an overview of the literature have reference to adverse events of olanzapine." 12/01/2006 - "[Akathisia in the course of olanzapine treatment]."
4.	aripiprazole (Abilify)FDA Link 08/01/2007 - "Thirteen (42%) patients met criteria for response (> or =50% reduction in MADRS total score), 11 (35%) patients met criteria for remission (final MADRS total score < or =12), and 9 (29%) patients discontinued aripiprazole for side effects, most commonly akathisia (N=4). " 07/01/2010 - "In conclusion, akathisia with aripiprazole occurred early in treatment, was mild-to-moderate in severity, led to few study discontinuations, and did not compromise therapeutic efficacy." 02/01/2009 - "Of 24 subjects in the intent-to-treat study group, 19 completed 12 weeks of augmentation with aripiprazole, 12 of 24 (50%) met criteria for remission, and 2 of 24 discontinued due to side effects (sedation, akathisia). " 12/12/2015 - "Akathisia was the most common adverse effect of aripiprazole (reported in 24 [26%] of 91 participants on aripiprazole vs 11 [12%] of 90 on placebo). " 11/01/2015 - "Aripiprazole-treated participants had better negative symptom outcomes but experienced more akathisia. "
5.	Haloperidol (Haldol)FDA LinkGeneric 06/01/2001 - "Haloperidol was associated with a non-significant reduction in LI scores, and dysphoria/akathisia (Barnes Akathisia Rating Scale) in three-quarters of the subjects. " 04/01/1993 - "Our study, therefore, replicates the findings of Sanberg (1980) and Russell et al. (1987a, 1987b) that haloperidol increases "emotional" defecation in rats in well-habituated environments, but the same model does not replicate the motor component of neuroleptic-induced akathisia seen in human subjects." 05/01/1983 - "[Biochemical and psychophysiological study of haloperidol-induced akathisia]." 09/01/2015 - "In telephone follow-up, 90% of subjects contacted were "happy with the medication" they had received, with haloperidol-treated subjects experiencing more restlessness (43% vs. 10%). " 01/01/2015 - "The only statistically significant difference in specific side effects was that haloperidol produced less akathisia in the medium term. "
6.	MianserinIBA 09/01/1997 - "Seven mianserin-treated patients improved and five revealed complete disappearance of neuroleptic-induced akathisia. " 09/01/1997 - "It contrast, it appears that low-dose mianserin is therapeutically effective in acute neuroleptic-induced akathisia." 10/04/2000 - "Improvement in a patient with severe akathisia achieved by mianserin]." 06/01/2010 - "Akathisia associated with mianserin." 03/01/1999 - "Mianserin at a low dose may be a promising therapeutic option for patients with acute neuroleptic-induced akathisia."
7.	Risperidone (Risperdal Consta)FDA LinkGeneric 10/01/2004 - "On the CMAI, risperidone was significantly more effective in treating hitting (p = .000), hurt self or other (p = .005), cursing or verbal aggression (p = .000), repetitive sentences or questions (p = .001), scratching (p = .041), general restlessness (p = .001), grabbing onto people (p = .028), constant request for attention (p = .041), pacing and aimless wandering (p = .013), and performing repetitious mannerisms (p = .045). " 12/01/2014 - "The daily risperidone dose on days 1, 2, and 3 was 6, 4, and 2 mg, respectively; risperidone was discontinued after day 3. On day 4, the patient exhibited a euphoric mood, with persistent laughing, expansive self-esteem, extreme talkativeness, flight of ideas, distractibility, and psychomotor agitation. " 07/01/2010 - "Fifty schizophrenic outpatients receiving stable doses of risperidone were evaluated for akathisia, schizophrenic symptoms, and subjective tolerability. " 09/01/2009 - "The results also suggest that EPS and akathisia continue to be major adverse effects associated with a low level of subjective well-being in patients receiving risperidone. " 03/01/2003 - "The patient demonstrated a reduction in restlessness in response to the use of risperidone, which permitted wound healing. "
8.	Fluoxetine (Prozac)FDA LinkGeneric 01/01/1996 - "Substantial emergence of psychomotor agitation also occurred at a similar incidence across the three treatment groups and typically appeared within the first 3 wk. Improvement in agitation was significantly more prominent (P < 0.001) among fluoxetine-treated than among placebo-treated patients. " 01/01/1996 - "Data derived from this large series of clinical trials suggested no evidence that either fluoxetine or TCAs induced psychomotor agitation at rates exceeding the natural course of the disorder over time (placebo cohort). " 09/01/1994 - "Recent studies have suggested, however, that fluoxetine (Prozac) may in fact lead to suicidal behavior because the drug appears to adversely affect serotonergic neuronal discharge and induce an akathisia-like extrapyramidal reaction. " 12/01/2003 - "The patient developed severe restlessness and de novo suicidal ideation approximately 1 week after the dosage of fluoxetine was doubled, 1 year on from when the drug was first introduced. " 12/01/2003 - "We report the case of a 22-year-old woman presenting major depressive episode with severe akathisia after an increase in fluoxetine. "
9.	Serotonin (5 Hydroxytryptamine)IBA 01/01/2015 - "Previous theory suggests antagonism of serotonin (5-HT)2A receptors may decrease akathisia risk. " 03/01/2014 - "Although cases of Selective Serotonin Reuptake Inhibitor (SSRI) induced akathisia have often been reported in literature, this adverse effect has not adequately been mentioned in major pharmacology textbooks. " 01/01/2011 - "More than 120 subjects were diagnosed with akathisia/serotonin toxicity after taking psychiatric medication that had been prescribed for psychosocial distress. " 03/01/2009 - "Selective serotonin reuptake inhibitor-induced akathisia." 06/01/2006 - "Preliminary evidence indicates a beneficial effect of serotonin 2A (5-HT(2A)) receptor antagonists in antipsychotic-induced akathisia (AIA). "
10.	mirtazapine (Rexer)FDA LinkGeneric 04/01/2006 - "The akathisia was successfully treated with mirtazapine, and 3 of the 4 depressed patients improved with mirtazapine treatment. " 05/01/2009 - "There is emerging evidence that mirtazapine may be useful in the treatment of acute akathisia. " 04/01/2006 - "The efficacy of mirtazapine in treatment of akathisia may result from its antagonist property at the H(1) receptors and its dopaminergic activity in frontal cortex. " 06/01/2003 - "Efficacy of low-dose mirtazapine in neuroleptic-induced akathisia: a double-blind randomized placebo-controlled pilot study." 10/01/2015 - "The study eligibility criteria were randomized, double-blind clinical trials comparing mirtazapine with placebo for AIAA with standardized rating for akathisia as outcome measure. "

Therapies and Procedures

1.	Subcutaneous Infusions 12/01/2011 - "Data on the total dose received in the last 24 h of life PRN and the last dose prescribed for administration via continuous subcutaneous infusion (CSCI) for agitation and restlessness were submitted. " 02/01/1993 - "It has proved effective in controlling terminal agitation, confusion, restlessness, dystonia and fitting in adults and can be given by subcutaneous infusion in combination with other drugs. " 08/01/1990 - "Midazolam by subcutaneous infusion is a well-tolerated, safe and effective treatment for terminal restlessness and agitation, and deserves more extensive evaluation." 08/01/1990 - "This article describes the use of a subcutaneous infusion of midazolam to control restlessness and agitation in 23 patients during the final stages of advanced cancer. " 07/01/1992 - "Sublingual lorazepam and continuous subcutaneous infusion of midazolam can be effective in controlling terminal restlessness."
2.	Drug Therapy (Chemotherapy) 09/01/2008 - "To evaluate the efficacy of pharmacotherapy on the symptoms of psychomotor agitation and aggressive behavior in a sample of patients with autistic spectrum disorder. " 01/01/1993 - "We present a case of neuroleptic induced akathisia resistant to traditional drug therapy which improved with electroconvulsive therapy. " 01/01/1996 - "Psychomotor agitation, a common clinical feature of major depression, may first emerge or intensify during pharmacotherapy. " 01/01/1996 - "These side effects, which include pseudoparkinsonism, acute dystonias, and akathisia, frequently are the reason for noncompliance with conventional drug therapy. " 11/01/1988 - "The dyskinetic signs that had been dramatically more severe in those patients exhibiting akathisia following withdrawal from antipsychotic medication continued for up to 6 weeks following the renewal of antipsychotic drug therapy. "
3.	Intramuscular Injections 09/01/2006 - "During the period of an unrelated observational study for patients with acute psychomotor agitation in a psychiatric emergency service, we noticed a significant reduction in the number of involuntary intramuscular injections administered. " 07/01/1987 - "Three acutely psychotic patients with psychomotor excitement and agitation were rapidly sedated following intramuscular injections of 2.5 mg to 3 mg of midazolam. " 10/01/1989 - "Patients with neuroleptic malignant syndrome displayed significantly greater psychomotor agitation, received significantly higher doses of neuroleptics at greater rates of dosage increase, and received a greater number of intramuscular injections than controls." 11/01/1998 - "The files of 183 hospitalized children and adolescents (93 boys, 90 girls) with severe psychiatric disorders were reviewed for serum creatine kinase activity on admission, psychomotor agitation, Clinical Global Impression Score, need for intramuscular injection, number of neuroleptic medications and presence of neuroleptic malignant syndrome. "
4.	Aftercare (After-Treatment) 03/01/2007 - "Comparison of the clinical manifestation before and after treatment showed significant improvement in volume of food intake, appetite, complexion and reduction of restlessness symptom (P<0.05) in all three groups, and there was no adverse reaction found in them. " 05/01/2000 - "After treatment, statistically significant decrements in Brief Psychiatric Rating Scale (BPRS) positive symptoms were noted, and individual items not directly related to the akathisia syndrome, such as conceptual disorganization, hallucinatory behavior, and unusual thought content declined, although not significantly. " 12/01/1999 - "After ring castration there was an increase in restlessness, in contrast to clamp castration, which had no obvious individual behaviour associated with it during the 4 hours after treatment. " 11/01/2012 - "After treatment, for the patients in both groups, the scores of the main associated symptoms such as anxiety, tension, insomnia, respiratory symptoms and the restlessness in conversation were all improved (all P<0.05). " 07/01/2008 - "ODI, pain score and restlessness score were 11.0+/-7.3, 5.0+/-1.9, 4.8+/-2.1 after treatment and 12.6+/-7.7, 6.5+/-1.8, 6.7+/-2.1 before treatment, respectively, with significant differences before and after treatment (all P < 0.05). "
5.	Anesthesia 08/01/2015 - "Anesthesia and lack of knowledge of what will happen, crying and restlessness of children increased preoperative anxiety. " 07/01/2008 - "The catheter inserting after the induction of anesthesia is an element related to the restlessness in anesthesia recovery period and other serious postoperative complications. " 07/01/2012 - "anoxemia, apnea, restlessness, nausea and vomiting), anesthesia duration and drug consumption were recorded. " 03/25/2014 - "anoxemia, apnea, bradycardia, restlessness, nausea, vomiting, crying and excitation), if any, anesthesia duration and drug consumption were recorded. " 09/01/2013 - "The patients recovered from anesthesia equally, but the degree of posttreatment disorientation and restlessness was more marked in the S-ketamine group. "