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Akathisia with haloperidol and thiothixene.

T Van Putten, P R May, S R Marder

    Archives of General Psychiatry
    |November 1, 1984
    PubMed
    Summary

    Schizophrenia patients treated with haloperidol experienced higher rates of akathisia, a distressing movement disorder, compared to those on thiothixene hydrochloride. This highlights a significant side effect of antipsychotic medications.

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    Area of Science:

    • Psychiatry
    • Clinical Pharmacology

    Background:

    • Akathisia is a common and distressing side effect of antipsychotic medications.
    • Early detection and management of akathisia are crucial for patient well-being and treatment adherence.

    Purpose of the Study:

    • To compare the incidence of akathisia in newly admitted schizophrenic patients treated with haloperidol versus thiothixene hydrochloride.
    • To characterize the severity and resistance to treatment of haloperidol-induced akathisia.

    Main Methods:

    • Two groups of newly admitted schizophrenic patients were studied.
    • One group received haloperidol, while the other received thiothixene hydrochloride.
    • Akathisia incidence was assessed after a test dose and during maintenance treatment.

    Main Results:

    • Within six hours of a 5-mg haloperidol test dose, 40% of patients experienced akathisia.
    • By day seven of maintenance treatment (10 mg haloperidol), 75% of patients developed akathisia.
    • Thiothixene hydrochloride resulted in lower akathisia rates: 20% after a test dose and 46% during maintenance.
    • Haloperidol-induced akathisia was often severe and treatment-resistant, manifesting as anxiety and depression.

    Conclusions:

    • Haloperidol is associated with a significantly higher incidence and severity of akathisia compared to thiothixene hydrochloride in schizophrenic patients.
    • The high rates and severity of akathisia underscore the need for vigilant monitoring and alternative treatment strategies.
    • Akathisia often goes undiagnosed, contributing to patient suffering and potentially impacting treatment outcomes.

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