Abstract | OBJECTIVE: To provide a brief description of the pathophysiology of akathisia, the challenges of diagnosing and treating this condition, and potential associated clinical issues. Also, to provide a review of the literature on the incidence of drug-induced akathisia associated with the use of second-generation antipsychotics (SGAs) and first-generation antipsychotics (FGAs). DATA SOURCES: STUDY SELECTION: Limits were set to search clinical trials, meta-analyses, or randomized controlled trials reviewing data from adult schizophrenia or bipolar disorder clinical trials. Studies including SGA comparisons with placebo and with FGAs, and also between SGAs themselves, were selected. Studies that specifically assessed akathisia (either subjectively or objectively or both) were included. Studies reporting generalized results pertaining to extrapyramidal symptoms (EPS) were excluded. DATA EXTRACTION: DATA SYNTHESIS: Seventy-seven trials were included in the comparative review. Akathisia was observed with the use of all the SGAs. The akathisia incidence reported in bipolar disorder trials was generally higher compared with schizophrenia trials. The incidence reported for FGAs was consistently higher than that reported for SGAs, regardless of the patient population studied. CONCLUSION:
Akathisia remains a concern with the use of SGAs. More accurate and standardized evaluations are required for a better understanding of the nature and incidence of akathisia.
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Authors | John M Kane, Wolfgang W Fleischhacker, Lars Hansen, Roy Perlis, Andrei Pikalov 3rd, Sheila Assunção-Talbott |
Journal | The Journal of clinical psychiatry
(J Clin Psychiatry)
Vol. 70
Issue 5
Pg. 627-43
(Apr 21 2009)
ISSN: 1555-2101 [Electronic] United States |
PMID | 19389331
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
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Copyright | Copyright 2009 Physicians Postgraduate Press, Inc. |
Chemical References |
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Topics |
- Akathisia, Drug-Induced
(etiology)
- Antipsychotic Agents
(adverse effects)
- Humans
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