Akathisia – side effects of psychiatric drugs

Side effect of antipsychotic and antidepressant drugs

AkathisiaAkathisia involves an inner restlessness, inner tension, anx... can exist in patients as a neurological condition but has now become much more common as a result of taking antipsychotic and antidepressant (selective serotonin reuptake inhibitor – SSRI) drugs.

It can be defined as:

“Subjectively, akathisiaAkathisia involves an inner restlessness, inner tension, anx... may present with an inner restlessness that involves mainly the legs but can also involve the arms or trunk, a compulsion to move, dysphoria [feeling of discomfort or distress], anxiety, inner tension, and other less common symptoms such as rage, fear, nausea, or worsening of psychotic symptoms. Objectively, akathisiaAkathisia involves an inner restlessness, inner tension, anx... may present with fidgetiness of the hands, arms, and limbs, complex repetitive movements, persistent swinging and crossing and uncrossing of the legs, moving from foot to foot, walking, and pacing.”

Fernando Espi Forcen, Konstantina Matsoukas and Yesne Alici. Antipsychotic-induced akathisiaAkathisia involves an inner restlessness, inner tension, anx... in delirium: A systematic review. ¹

This video was produced by Aimee & Josh Jensen as an educational video regarding Josh’s akathisiaAkathisia involves an inner restlessness, inner tension, anx... and dystoniaDystonia is a movement disorder that causes the muscles to c... condition as a result of taking medication. Josh was given further drugs to handle the initial akathisiaAkathisia involves an inner restlessness, inner tension, anx... condition but these brought on dystoniaDystonia is a movement disorder that causes the muscles to c... (muscles contracting involuntarily causing repetitive twisting movements).

Psychiatry in DSM V defines two types of akathisiaAkathisia involves an inner restlessness, inner tension, anx....

The first is medication-induced akathisiaAkathisia involves an inner restlessness, inner tension, anx... which results from starting or raising a medication dose or reducing other medication taken to handle involuntary movement symptoms.

The second is ‘tardiveAppearing late, e.g. appearing late in the history of taking... akathisia’ which can occur late in the course of treatment, usually three months after medicine or dose change, and which can go on for months or years even when no longer on medications or dosage reduction.

A 2017 paper on the state of the condition found very high rates of akathisiaAkathisia involves an inner restlessness, inner tension, anx... in various psychiatric treatment situations:

• Patients with schizophrenia were found with 24% having chronic akathisiaAkathisia involves an inner restlessness, inner tension, anx... and 18% “pseudoakathisia” [only having objective symptoms]
• For patients treated with clozapine, akathisiaAkathisia involves an inner restlessness, inner tension, anx... rates were 39%.
• For patients treated with first-generation antipsychotics, the rate was 45%.
• A study to determine the prevalence of global akathisiaAkathisia involves an inner restlessness, inner tension, anx... in a community-dwelling sample of patients with schizophrenia found rates of 15 to 35%.
• Bipolar I (manicDescribing behavior consisting of unstable elevated or irrit... More depression) patients who were taking antidepressants will develop akathisiaAkathisia involves an inner restlessness, inner tension, anx... in 10 to 18% of cases.

AkathisiaAkathisia involves an inner restlessness, inner tension, anx... was first observed after the first antipsychotic chlorpromazine was first introduced in 1952. Despite it now being 70 years later psychiatry has no definitive idea of what causes akathisiaAkathisia involves an inner restlessness, inner tension, anx....

Various attempts to handle the condition through lessening dosage, and changing medications may alleviate however there is no guarantee anything will work. Despite its appalling effects on patients, it is an area given little attention by psychiatry. ^{2 3 4}

AkathisiaAkathisia involves an inner restlessness, inner tension, anx... can result in violent behavior and reports of resulting homicidal tendencies exist. ^{5 6}

The subjective stresses produced can result in extreme anxiety and a depressed mood and risk of suicide, particularly through mis or no diagnosis of the condition. ⁷

The risk of akathisiaAkathisia involves an inner restlessness, inner tension, anx... with SSRI antidepressants was known and yet withheld for years until finally disclosed. For example, it was known that 3.5% of ProzacA brand name for the antidepressant fluoxetine. More patients either attempted or committed suicide due to the stresses of akathisiaAkathisia involves an inner restlessness, inner tension, anx....

At the time a Pfizer employee, Roger Lane, stated in a 1998 paper:

“It may be less of a question of patients experiencing fluoxetine-induced suicidal ideation than patients feeling that ‘death is a welcome result’ when the acutely discomforting symptoms of akathisiaAkathisia involves an inner restlessness, inner tension, anx... are experienced on top of already distressing disorders.”

Roger Lane. ⁸