The incidence of akathisia in bipolar affective disorder treated with neuroleptics--a preliminary report.
BACKGROUND
Akathisia is a common side effect of neuroleptic therapy. Prevalence and incidence studies of akathisia have been predominantly undertaken in patients with schizophrenia and schizoaffective disorder. Investigations of akathisia in neuroleptic treated patients suffering from bipolar disorder are lacking.


METHODS
In the present study, 23 patients with bipolar affective disorder who were treated with neuroleptics were assessed for akathisia and parkinsonism, using the Barnes Akathisia Rating Scale and DSM-IV criteria, respectively.


RESULTS
15 patients (65.2%) developed akathisia. Eighteen patients (78.3%) had parkinsonism, including all of the akathisia-group. In six patients (40%) of the akathisia-group the onset of akathisia was after neuroleptic dose reduction or after additional administration of mood stabilizers.


CONCLUSIONS
Neuroleptic-induced side effects may occur frequently in patients with bipolar affective disorder and should therefore be monitored thoroughly. Demasking effects due to diminishing parkinsonian symptoms may contribute to akathisia-onset after neuroleptic dose reduction. Early application of alternative treatment regimens, e.g. monotherapy with mood stabilizers in combination with benzodiazepines should be considered.


CONCLUSIONS
The preliminary findings require further investigation regarding dose dependency, incidence of akathisia in untreated patients with bipolar affective disorder, akathisia in patients with depressed episodes on SSRI, and possible differences between various mood stabilizers in their propensity to enhance akathisia, as well as possible sex differences.
Brüne
M
M
Department of Psychiatry and Psychotherapy, Ruhr-University of Bochum, Germany. Martin.Bruene@ruhr-uni-bochum.de
D000328:Adult; D017109:Akathisia, Drug-Induced / Q000175:diagnosis*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D012720:Severity of Illness Index
D017367:Selective Serotonin Reuptake Inhibitors