title: Evaluation of akathisia in patients with schizophrenia, schizoaffective disorder, or bipolar I disorder: a post hoc analysis of pooled data from short- and long-term aripiprazole trials.
abstract: The objective of this article is to assess the clinical characteristics of akathisia in patients with schizophrenia, schizoaffective disorder, or bipolar I disorder receiving aripiprazole, haloperidol, olanzapine, or placebo. We conducted post hoc analyses of pooled safety data from trials in patients with schizophrenia, schizoaffective disorder, and bipolar I disorder. Outcome measures included the incidence of akathisia, time to onset, duration, severity, and discontinuation due to akathisia, concomitant use of benzodiazepines and/or anticholinergics, Barnes Akathisia Rating Scale (BARS) scores, and the correlation between antipsychotic efficacy and akathisia. The results for schizophrenia and schizoaffective disorder were as follows: akathisia in 9% of aripiprazole- and 6% of placebo-treated patients; 12.5% of aripiprazole- versus 24% of haloperidol-treated patients; 11% of aripiprazole- versus 6% of olanzapine-treated patients. Bipolar I disorder: akathisia in 18% of aripiprazole- and 5% of placebo-treated patients. The clinical characteristics of akathisia were similar between each data set, regardless of disease. Akathisia was generally mild-to-moderate in severity. Discontinuation due to akathisia was low in both the schizophrenia trials (aripiprazole 0.3%; placebo 0%; aripiprazole 0.9%; haloperidol 2.3%; aripiprazole 1.2%; olanzapine 0.2%) and the bipolar trials (aripiprazole 2.3%; placebo 0%). Treatment-emergent akathisia was not associated with a poorer clinical response. In conclusion, akathisia with aripiprazole occurred early in treatment, was mild-to-moderate in severity, led to few study discontinuations, and did not compromise therapeutic efficacy.
authors.affiliation: The Zucker Hillside Hospital, Glen Oaks, NY 11004, USA. psychiatry@lij.edu
authors.forename: John M
authors.initials: JM
authors.lastname: Kane
authors.forename: Thomas R E
authors.initials: TR
authors.lastname: Barnes
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.forename: Gary
authors.initials: G
authors.lastname: Sachs
authors.forename: Peter
authors.initials: P
authors.lastname: Buckley
authors.forename: James
authors.initials: J
authors.lastname: Eudicone
authors.forename: Robert
authors.initials: R
authors.lastname: McQuade
authors.forename: Quynh-Van
authors.initials: QV
authors.lastname: Tran
authors.forename: Andrei
authors.initials: A
authors.lastname: Pikalov
authors.forename: Sheila
authors.initials: S
authors.lastname: Assunção-Talbott
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000068180:Aripiprazole; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000150:complications* / Q000523:psychology*; D004311:Double-Blind Method; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D000077152:Olanzapine; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000188:drug therapy / Q000523:psychology*; D011618:Psychotic Disorders / Q000150:complications* / Q000523:psychology*; D015363:Quinolones / Q000009:adverse effects* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D010879:Piperazines; D015363:Quinolones; D001569:Benzodiazepines; D000068180:Aripiprazole; D006220:Haloperidol; D000077152:Olanzapine