Delayed-onset akathisia due to amisulpride.

Area of Science:

• Psychiatry and Pharmacology
• Neuroscience
• Clinical Therapeutics

Background:

• Second-generation antipsychotics (SGAs) have a lower risk of extrapyramidal side-effects (EPS) than older agents.
• However, akathisia, a distressing form of EPS, can still occur with SGAs.
• Emerging evidence suggests potential pharmacological differences between acute and tardive akathisia.

Purpose of the Study:

• To investigate the incidence and characteristics of delayed-onset akathisia in patients receiving amisulpride monotherapy.
• To evaluate the role of amisulpride in the development of akathisia.

Main Methods:

• A prospective study screened 56 patients on stable amisulpride doses for 2 months.
• Patients meeting Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for acute or delayed-onset akathisia were assessed.
• The Positive and Negative Syndrome Scale (PANSS) and Barnes Akathisia Scale (BAS) were used for evaluation at baseline and symptom presentation.

Main Results:

• 12 out of 56 patients (21.4%) developed delayed-onset akathisia, with a mean onset time of 39.4 ± 11.3 days.
• Six patients (10.7%) experienced acute akathisia, with a mean onset time of 5.8 ± 2.1 days.
• Mean BAS scores significantly increased from baseline (1.3 ± 0.6) to symptom presentation (3.9 ± 2.4) (P < 0.001).

Conclusions:

• Amisulpride monotherapy is associated with a considerable risk of developing delayed-onset akathisia.
• Further research with larger sample sizes and diverse antipsychotics is needed to confirm these findings.
• Comprehensive assessments are crucial for understanding the full spectrum of amisulpride-induced akathisia.