Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-17T05:12:02.826Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical Characteristics of Akathisia

A Systematic Investigation of Acute Psychiatric Inpatient Admissions

Published online by Cambridge University Press:  29 January 2018

Walter M. Braude ,
Thomas R. E. Barnes  and
Sheila M. Gore
Walter M. Braude
Affiliation:
Psychiatric Research Unit, University of Cambridge Clinical School, Addenbrooke's Hospital, Cambridge CB2 2QE
Thomas R. E. Barnes
Affiliation:
Psychiatric Research Unit, University of Cambridge Clinical School, Addenbrooke's Hospital, Cambridge CB2 2QE
Sheila M. Gore
Affiliation:
MRC Biostatistics Unit, MRC Centre, Hills Road, Cambridge
Get access Rights & Permissions [Opens in a new window]

Summary

Assessment of drug-induced movement disorders was carried out regularly on 104 psychiatric patients requiring antipsychotic medication on admission to hospital. The data relevant to motor restlessness were subjected to a principal components' analysis. According to their component scores, patients were then classified into two main groups: an akathisia group and an illness-related-movement group, the former group showing the clinical and pharmacological characteristics expected of akathisia. Clinical features which distinguished between the two groups, and between grades of akathisia severity, were identified, so an objective, phenomenological description of the akathisia syndrome was possible. Our observations suggested two distinct types of acute akathisia; one related to severe parkinsonism and one not. The implications of these findings are discussed.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 143 , Issue 2 , August 1983 , pp. 139 - 150
Copyright
Copyright © 1983 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ayd, F. J. (1961) A survey of drug-induced extrapyramidal reactions. Journal of the American Medical Association, 175, 1054–60.Google ScholarPubMed
Barnes, T. R. E., Braude, W. M. & Hill, D. J. (1982) Acute akathisia after oral droperidol and metoclopramide preoperative medication. Lancet, 2, 48–9.Google ScholarPubMed
Barnes, T. R. E. & Trauer, T. (1982) Reliability and validity of a tardive dyskinesia videotape rating technique. British Journal of Psychiatry, 140, 508–15.CrossRefGoogle ScholarPubMed
Behrman, S. (1958) Disturbed relaxation of the limbs. British Medical Journal, 1, 1454–7.CrossRefGoogle Scholar
Boghen, D. & Peyronnard, J. M. (1976) Myoclonus in familial restless legs syndrome. Archives of Neurology, 33, 368–70.CrossRefGoogle ScholarPubMed
Brandon, S., McClelland, H. A. & Protheroe, C. (1971) A study of facial dyskinesia in a mental hospital population. British Journal of Psychiatry, 118, 171–84.CrossRefGoogle Scholar
Carp, J. S. & Anderson, R. J. (1982) Dopamine receptor-mediated depression of spinal monosynaptic transmission. Brain Research, 242, 247–54.CrossRefGoogle ScholarPubMed
Carter, C. J. & Pycock, C. J. (1980) Behavioural and biochemical effects of dopamine and noradrenaline depletion within the medial prefrontal cortex of the rat. Brain Research, 192, 163–76.CrossRefGoogle ScholarPubMed
Crane, G. E., Naranjo, E. R. & Chase, C. (1971) Motor disorders induced by neuroleptics. Archives of General Psychiatry, 24, 179–84.CrossRefGoogle ScholarPubMed
Davis, J. M. (1974) Dose equivalence of the antipsychotic drugs. Journal of Psychiatric Research, 11, 65–9.Google Scholar
Degwitz, R. & Wenzel, W. (1967) Persistent extrapyramidal side-effects after long-term application of neuroleptics. In Neuropsychopharmacology (eds. Brill, H., Cole, J. O., Hippius, H. and Bradley, P. B.), pp 608–18. Excerpta Medica International Congress Series 129. Amsterdam: Excerpta Medica Foundation.Google Scholar
Delay, J & Deniker, P. (1968) Drug-induced extrapyramidal syndromes. In Handbook of Clinical Neurology (eds. Vinken, P. J. and Bruyn, G. W.), pp 248–66, Vol. 6. Amsterdam: North Holland.Google Scholar
Director, K. L. & Muniz, C. E. (1982) Diazepam in the treatment of extrapyramidal symptoms: A case report. Journal of Clinical Psychiatry, 43, 160–1.Google ScholarPubMed
Donlon, P. T. (1973) The therapeutic use of diazepam for akathisia. Psychosomatics, 14, 222–5.CrossRefGoogle ScholarPubMed
Ezrin-Waters, C., Seeman, M. V. & Seeman, P. (1981) Tardive dyskinesia in schizophrenic outpatients: prevalent and significant variables. Journal of Clinical Psychiatry, 42, 16–22.Google Scholar
Forrest, D. V. & Fahn, S. (1979) Tardive dysphrenia and subjective akathisia. Journal of Clinical Psychiatry, 40, 206.Google ScholarPubMed
Gagrat, D., Hamilton, J. & Belmaker, R. H. (1978) Intravenous diazepam in the treatment of neuroleptic-induced acute dystonia and akathisia. American Journal of Psychiatry, 135, 1232–3.Google ScholarPubMed
Garside, R. F. & Roth, M. (1978) Multivariate statistical methods and problems of classification in psychiatry. British Journal of Psychiatry, 133, 53–67.CrossRefGoogle ScholarPubMed
Halliday, A. M. (1967) The clinical incidence of myoclonus. In Modern Trends in Neurology 4 (ed Williams, D.), pp 69–105. London: Butterworths.Google Scholar
Hodge, J. R. (1959) Akathisia: the syndrome of motor restlessness. American Journal of Psychiatry, 116, 337–8.Google ScholarPubMed
Hussey, H. H. (1976) Restless legs syndrome. Journal of the American Medical Association, 235, 2224.Google Scholar
Iversen, S. D. (1971) The effect of surgical lesions to frontal cortex and substania nigra on amphetamine responses in rats. Brain Research, 31, 295–311.Google Scholar
Jungmann, E. & Schöffling, K. (1982) Akathisia and metoclopramide. Lancet, 2, 221.Google Scholar
Kekich, W. A. (1978) Neuroleptics: violence as a manifestation of akathisia. Journal of the American Medical Association, 240, 2185.CrossRefGoogle Scholar
Kennedy, P. F., Hershon, H. I. & McGuire, R. J. (1971) Extrapyramidal disorders after prolonged phenothiazine therapy. British Journal of Psychiatry, 118, 509–18.Google Scholar
Koob, G. F., Stinus, L. & Le Moal, M. (1981) Hyperactivity and hypoactivity produced by lesions to the mesolimbic dopamine system. Behavioural Brain Research, 3, 341–59.Google Scholar
Kumar, B. B. (1979) An unusual case of akathisia. American Journal of Psychiatry, 136, 1088.Google ScholarPubMed
Marsden, C. D. & Jenner, P. (1980) The pathophysiology of extrapyramidal side-effects of neuroleptic drugs. Psychological Medicine, 10, 55–72.Google Scholar
Marsden, C. D., Tarsy, D. & Baldessarini, R. J. (1975) Spontaneous and drug-induced movement disorders in psychotic patients. In Psychiatric Aspects of Neurological Disease (eds. Benson, D. F. and Blumer, D.), pp 219–65. New York: Grune and Stratton.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The brief psychiatric rating scale. Psychological Reports, 10, 799–812.Google Scholar
Pycock, C. J., Kerwin, R. W. & Carter, C. J. (1980a) Effect of lesion of cortical dopamine terminals on subcortical dopamine receptors in rats. Nature, 286, 74–7.Google Scholar
Pycock, C. J., Carter, C. J. & Kerwin, R. W. (1980b) Effect of 6-hydroxydopamine lesions of the medial prefrontal cortex on neurotransmitter systems in subcortical sites in the rat. Journal of Neurochemistry, 34, 91–9.Google Scholar
Raskin, D. E. (1972) Akathisia: a side-effect to be remembered. American Journal of Psychiatry, 129, 345–7.Google Scholar
Research Group on Extrapyramidal Disorders of the World Federation of Neurology (1981) Classification of extrapyramidal disorders: proposal for an international classification and glossary of terms. Journal of the Neurological Sciences, 51, 311–27.Google Scholar
Sigwald, J. & Raymondeaud, C. I. (1968) Les réactions désagréables ou douloureuses de la maladie de parkinson et de la thérapeutique neuroleptique (paresthésies impatiences, crampes, akathisie). Leur amélioration par l'alimémazine. Semaine des Hôpitaux de Paris, 4, 2897–9.Google Scholar
Sigwald, J. & Solgnac, J. (1968) Manifestations douloureuses de la maladie de Parkinson et paresthésies provoquées par les neuroleptiques. Semaine des Hôpitaux de Paris, 36, 2222–5.Google Scholar
Simpson, G. M. (1977) Neurotoxicology of major tranquillisers. In Neurotoxicology (eds. Roizin, L., Shiraki, H. and Grćević, N.), Vol. 1., pp 1–7. New York: Raven Press.Google Scholar
Simpson, G. M. & Angus, J. W. S. (1970) A rating scale for extrapyramidal side-effects. Acta Psychiatrica Scandinavica, 212, 11–9.Google Scholar
Sovner, R. & DiMascio, A. (1978) Extrapyramidal syndromes and other neurological side-effects of psychotropic drugs. In Psychopharmacology: A Generation of Progress (eds. Lipton, M. A., DiMascio, A & Killam, K. F.), pp 1021–32. New York: Raven Press.Google Scholar
Tassin, J-P., Stinus, L., Simon, H., Blanc, G., Thierry, A-M., Le Moal, M., Cardo, B. & Glowinski, J. (1978) Relationship between the locomotor hyperactivity induced by A10 lesions and the destruction of the fronto-cortical dopaminergic innervation in the rat. Brain Research, 141, 267–81.Google Scholar
Van Putien, T. (1974) Why do schizophrenic patients refuse to take their drugs? Archives of General Psychiatry, 31, 67–72.Google Scholar
Van Putien, T. (1975) The many faces of akathisia. Comprehensive Psychiatry, 16, 43–7.Google Scholar
Van Putien, T. (1978) Drug refusal in schizophrenia: causes and prescribing hints. Hospital and Community Psychiatry, 29, 110–2.Google Scholar
Wyatt, R. J. & Togrow, J. S. (1976) A comparison of equivalent clinical potencies of neuroleptics as used to treat schizophrenia and affective disorders. Journal of Psychiatric Research, 13, 91–8.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.