A critical review of akathisia, and its
possible association with suicidal behaviour
by
Hansen L.
Mental Health Group,
University of Southampton,
Southampton, UK.
Hum Psychopharmacol. 2001 Oct;16(7):495-505

ABSTRACT

The purpose of this paper was to make a critical review of akathisia, based on the principles of evidence-based medicine, and to explore a possible link between akathisia and suicidal behaviour (suicidal thinking, parasuicide and completed suicide). An extensive systematic search was carried out on three major databases, Embase, ClinPsych and Medline. Fifty-seven relevant references were found, and a further 26 references were reviewed after careful selection from the references of the original references. The Cochrane Library did not contain any systematic reviews on the subject. Akathisia can be caused by several different groups of drugs, but most frequently by antipsychotics and to a lesser extent antidepressants. Research into akathisia is made considerably more difficult by the lack of a universally agreed definition of the condition. The underlying pathophysiology is still far from clear, but the literature offers guidelines on less hazardous management regimes for patients. On the basis of the existing literature, akathisia cannot at this stage unequivocally be linked to suicidal behaviour. It is certain, however, that the condition of akathisia does cause considerable distress in an already vulnerable group of patients. Because it is largely avoidable, new, more rigorous strategies must be put in place to prevent it.

Akathisia
Dopamine
Valproate
Fluoxetine
Olanzapine
Haloperidol
Trimipramine
Chlorpromazine
Benzodiazepines
SSRI suicide link?
The David Healy Affair
Schizoaffective disorder
Fluoxetine and akathisia
SSRI-induced extrapyramidal side-effects and akathisia

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