[Akathisia due to risperidone withdrawal: two clinical cases]

Area of Science:

• Neuroscience
• Pharmacology
• Clinical Psychiatry

Background:

• Akathisia is a rare extrapyramidal side effect associated with antipsychotic medications.
• Its occurrence during drug withdrawal is poorly understood and infrequently documented.
• Existing literature has limited reported cases, particularly concerning specific antipsychotics like risperidone.

Observation:

• This study details two distinct clinical cases of patients experiencing akathisia after discontinuing risperidone treatment.
• Case 1: Akathisia emerged during high-to-medium dose risperidone treatment and intensified upon withdrawal.
• Case 2: Akathisia manifested immediately after a nine-month course of low-dose risperidone therapy.

Findings:

• The findings indicate that akathisia can develop subsequent to risperidone withdrawal, irrespective of prior dosage or treatment duration.
• This presentation challenges the notion that akathisia is solely linked to acute treatment phases or higher dosages.
• The observed cases contribute to the limited body of evidence on withdrawal-induced akathisia.

Implications:

• These observations underscore the importance of considering akathisia in patients presenting with restlessness or movement abnormalities after antipsychotic discontinuation.
• Further research is warranted to elucidate the precise mechanisms underlying withdrawal-induced akathisia and to establish clear diagnostic and management guidelines.
• Clinicians should maintain a high index of suspicion for akathisia when managing patients on or withdrawing from risperidone and other antipsychotics.