Is akathisia associated with poor clinical response to antipsychotics during acute hospital treatment?

Previous studies have suggested that akathisia is associated with poor acut e clinical response to antipsychotics and that low serum iron levels are as sociated with emergence of akathisia. To examine these relationships during routine clinical treatment, we studied patients with DSM-IV schizophrenia or schizoaffective disorder undergoing hospital treatment for acute psychot ic exacerbations with doctor's choice medications. There were 34 subjects o bserved for at least 2 weeks. They were assessed at baseline and weekly by one rater with the Anchored Brief Psychiatric Rating Scale and by another r ater with the Barnes Rating Scale for akathisia, with the two raters blind to each other's ratings. Serum ferritin and transferrin levels were obtaine d at baseline. Seventeen subjects developed akathisia. Subjects with and wi thout akathisia did not differ in change in thinking disturbance or anxiety -depression scares over 2 weeks, or in serum ferritin or transferrin levels . We conclude that mild akathisia by itself is not strongly associated with initial response to low to moderate doses of antipsychotics in the acute c linical setting. Limitations of the study are discussed. (C) 2000 Elsevier Science Inc.