Clinical correlates of akathisia in acute psychiatric inpatients

This study identified acute and chronic akathisia in acute psychiatric inpa tients receiving conventional antipsychotic medication, and evaluated the c linical characteristics, risk factors and clinical implications of the cond ition. Akathisia and other movement disorders were systematically assessed in patients consecutively admitted to an acute psychiatric ward over one ye ar. Akathisia,vas diagnosed in 15 (21%) of 72 patients. Akathisia, developi ng as an acute condition in seven patients, generally presented with the su bjective experience of dysphoria and unease without restless movements. Thi s acute akathisia developed during the first few days of hospitalization an d was associated with both a higher average dose of antipsychotic medicatio n and a greater increase in dosage. In the remaining eight cases, akathisia was already present on admission, and thus classified as chronic. Those pa tients with chronic akathisia exhibited both subjective restlessness and th e characteristic restless movements. Chronic akathisia was unrelated to ant ipsychotic dosage. The proportion of patients with akathisia who discontinu ed drug treatment was significantly higher than that for patients without t he condition. Patients with acute akathisia tended to drop-out of treatment and those with the chronic form tended to have treatment withdrawn by the prescribing clinician. One interpretation is that the subjective distress o f acute akathisia may be particularly difficult for patients to tolerate an d leads them to stop medication, while patients with more chronic akathisia may have become more accepting of the experience. Repetitive movements of the legs were observed more commonly in those with chronic rather than acut e akathisia, and may represent a way of achieving some limited respite. Int Clin Psychopharmacol 15:215-219 (C) 2000 Lippincott Williams & Wilkins.