In-depth analysis of antipsychotic-induced akathisia: An integrative literature review
DOI:
https://doi.org/10.33448/rsd-v13i10.47011Keywords:
Akathisia, Antipsychotics, Movement disorders, Dopaminergic pathways, Dopamine.Abstract
Background: Antipsychotic-induced akathisia poses a significant challenge in clinical practice due to its frequent oversight in diagnosis and associated severe consequences such as suicidal behavior and compromised treatment adherence. Understanding the underlying mechanisms and implementing effective management strategies are imperative in addressing this clinical concern. Objective: provide an updated understanding of the correlation between antipsychotics and akathisia, discussing its pathophysiology, diagnosis, assessment, and current as well as prospective treatment options. Methods: An integrative literature review was conducted utilizing Pubmed and Virtual Health Library databases, supplemented by additional resources to broaden the study's scope. Results and Discussion: Among the 204 studies analyzed, 17 met the criteria for inclusion in the review, complemented by 7 articles focusing on assessment scales. The study explores the impact of neuroleptic medications on akathisia's pathophysiology, diagnostic approaches, symptomatology, assessment tools, and management strategies. Conclusion: Robust research endeavors are crucial to consolidate evidence, identify gaps, and offer a holistic perspective on akathisia. The profound comprehension of the condition reveals paths to enhance patients' quality of life.
Downloads
References
Ali, T., Sisay, M., Tariku, M., Mekuria, A. N., & Desalew, A. (2021). Antipsychotic-induced extrapyramidal side effects: A systematic review and meta-analysis of observational studies. PloS One, 16(9), e0257129. https://doi.org/10.1371/journal.pone.0257129
Barnes, T. R. E. (1989). A rating scale for drug-induced akathisia. The British Journal of Psychiatry: The Journal of Mental Science, 154(5), 672–676. https://doi.org/10.1192/bjp.154.5.672
Campos, G., Ramírez, N., Seguic, C., Strube, L., & Abufhele, M. (2021). Antipsychotic-induced akathisia: recommendations for clinical practice. Revista Chilena De-Psiquiatria y Neurologia de La Infancia y Adolescencia, 32(1), 89–96.
Cassady, S. L., Thaker, G. K., Summerfelt, A., & Tamminga, C. A. (1997). The Maryland Psychiatric Research Center scale and the characterization of involuntary movements. Psychiatry Research, 70(1), 21–37. https://doi.org/10.1016/s0165-1781(97)03031-x
Chouinard, G., & Margolese, H. C. (2005). Manual for the Extrapyramidal Symptom Rating Scale (ESRS). Schizophrenia Research, 76(2–3), 247–265. https://doi.org/10.1016/j.schres.2005.02.013
Chouinard, G., Ross-Chouinard, A., Annable, L., & Jones, B. (1980). The extrapyramidal symptoms rating scale. Canadian Journal of Neurological Sciences, 7, 233.
Chow, C. L., Kadouh, N. K., Bostwick, J. R., & VandenBerg, A. M. (2020). Akathisia and newer second-generation antipsychotic drugs: A review of current evidence. Pharmacotherapy, 40(6), 565–574. https://doi.org/10.1002/phar.2404
Demyttenaere, K., Detraux, J., Racagni, G., & Vansteelandt, K. (2019). Medication-induced akathisia with newly approved antipsychotics in patients with a severe mental illness: A systematic review and meta-analysis. CNS Drugs, 33(6), 549–566. https://doi.org/10.1007/s40263-019-00625-3
Friedman, J. H. (2020). Movement disorders induced by psychiatric drugs that do not block dopamine receptors. Parkinsonism & Related Disorders, 79, 60–64. https://doi.org/10.1016/j.parkreldis.2020.08.031
Inada, T. (1996). Evaluation and Diagnosis of Drug-induced Extrapyramidal Symptoms: Commentary on the DIEPSS and Guide to its Usage. Tokyo: Seiwa Shoten Publishers.
Inada, T, Yagi, G., & Miura, S. (2002). Extrapyramidal symptom profiles in Japanese patients with schizophrenia treated with olanzapine or haloperidol. Schizophrenia Research, 57(2–3), 227–238. https://doi.org/10.1016/s0920-9964(01)00314-0
Lima, A. R., Bacalcthuk, J., Barnes, T. R. E., & Soares-Weiser, K. (2004). Central action beta-blockers versus placebo for neuroleptic-induced acute akathisia. Cochrane Database of Systematic Reviews, 4, CD001946. https://doi.org/10.1002/14651858.CD001946.pub2
Lima, A. R., Soares-Weiser, K., Bacaltchuk, J., & Barnes, T. R. (2002). Benzodiazepines for neuroleptic-induced acute akathisia. Cochrane Database of Systematic Reviews, 1, CD001950. https://doi.org/10.1002/14651858.CD001950
Martino, D., Karnik, V., Bhidayasiri, R., Hall, D. A., Hauser, R. A., Macerollo, A., Pringsheim, T. M., Truong, D., Factor, S. A., Skorvanek, M., Schrag, A., & Members of the IPMDS Rating Scales Review Committee. (2023). Scales for antipsychotic-associated movement disorders: Systematic review, critique, and recommendations. Movement Disorders: Official Journal of the Movement Disorder Society, 38(6), 1008–1026. https://doi.org/10.1002/mds.29392
Matson, J. L., Mayville, E. A., Bielecki, J., Barnes, W. H., Bamburg, J. W., & Baglio, C. S. (1998). Reliability of the Matson Evaluation of Drug Side Effects scale (MEDS). Research in Developmental Disabilities, 19(6), 501–506. https://doi.org/10.1016/s0891-4222(98)00021-3
Musco, S., Ruekert, L., Myers, J., Anderson, D., Welling, M., & Cunningham, E. A. (2019). Characteristics of patients experiencing extrapyramidal symptoms or other movement disorders related to dopamine receptor blocking agent therapy. Journal of Clinical Psychopharmacology, 39(4), 336–343. https://doi.org/10.1097/JCP.0000000000001061
Nagaoka, K., Nagayasu, K., Shirakawa, H., & Kaneko, S. (2023). Acetaminophen improves tardive akathisia induced by dopamine D2 receptor antagonists. Journal of Pharmacological Sciences, 151(1), 9–16. https://doi.org/10.1016/j.jphs.2022.10.006
Poyurovsky, M., & Weizman, A. (2018). Very low-dose mirtazapine (7.5 mg) in treatment of acute antipsychotic-associated akathisia. Journal of Clinical Psychopharmacology, 38(6), 609–611. https://doi.org/10.1097/JCP.0000000000000972
Poyurovsky, M., & Weizman, A. (2020). Treatment of antipsychotic-induced akathisia: Role of serotonin 5-HT2a receptor antagonists. Drugs, 80(9), 871–882. https://doi.org/10.1007/s40265-020-01312-0
Rathbone, J., & Soares-Weiser, K. (2006). Anticholinergics for neuroleptic-induced acute akathisia. Cochrane Database of Systematic Reviews, 4, CD003727. https://doi.org/10.1002/14651858.CD003727.pub3
Shahidi, G., Rohani, M., Munhoz, R. P., & Akhoundi, F. H. (2018). Tardive akathisia with asymmetric and upper-body presentation: Report of two cases and literature review. Tremor and other hyperkinetic movements (New York, N.Y.), 8(0), 563. https://doi.org/10.5334/tohm.415
Sienaert, P., van Harten, P., & Rhebergen, D. (2019). The psychopharmacology of catatonia, neuroleptic malignant syndrome, akathisia, tardive dyskinesia, and dystonia. Handbook of Clinical Neurology, 165, 415–428. https://doi.org/10.1016/B978-0-444-64012-3.00025-3
Souza, M. T. de, Silva, M. D. da, & Carvalho, R. de. (2010). Integrative review: what is it? How to do it? Einstein (Sao Paulo, Brazil), 8(1), 102–106. https://doi.org/10.1590/S1679-45082010RW1134
Takeshima, M., Ishikawa, H., Kikuchi, Y., Kanbayashi, T., & Shimizu, T. (2018). Successful management of clozapine-induced akathisia with gabapentin enacarbil: A case report. Clinical Psychopharmacology and Neuroscience: The Official Scientific Journal of the Korean College of Neuropsychopharmacology, 16(3), 346–348. https://doi.org/10.9758/cpn.2018.16.3.346
Thippaiah, S. M., Fargason, R. E., & Birur, B. (2021). Struggling to find Effective Pharmacologic Options for Akathisia? B-CALM! Psychopharmacology Bulletin, 51(3), 72–78.
Wu, H., Siafis, S., Wang, D., Burschinski, A., Schneider-Thoma, J., Priller, J., Davis, J. M., & Leucht, S. (2023). Antipsychotic-induced akathisia in adults with acute schizophrenia: A systematic review and dose-response meta-analysis. European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology, 72, 40–49. https://doi.org/10.1016/j.euroneuro.2023.03.015
Yang, H.-J., Kim, S.-G., Seo, E. H., & Yoon, H.-J. (2022). Amisulpride withdrawal akathisia responding to aripiprazole with propranolol in first-onset psychosis: a case report. BMC Psychiatry, 22(1), 74. https://doi.org/10.1186/s12888-022-03721-9
Zareifopoulos, N., Katsaraki, M., Stratos, P., Villiotou, V., Skaltsa, M., Dimitriou, A., Karveli, M., Efthimiou, P., Lagadinou, M., & Velissaris, D. (2021). Pathophysiology and management of Akathisia 70 years after the introduction of the chlorpromazine, the first antipsychotic. European Review for Medical and Pharmacological Sciences, 25(14), 4746–4756. https://doi.org/10.26355/eurrev_202101_26386
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Mauro Marques Lopes; Gustavo Coutinho Nogueira Pereira; Bruna Carvalho Veloso; Yuri Costa Anjos; Mariana de Sousa Vilela Silva; Fabiana Alves; Bárbara Faria Corrêa Vilela; Edmar Geraldo Ribeiro; Vinícius Corrêa da Silva Rocha
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
