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Incidence and risk factors of acute akathisia in 493 individuals with first episode non-affectivepsychosis: a 6-week randomised study of antipsychotic treatment

Abstract: INTRODUCTION: Acute akathisia is a neuropsychiatric syndrome with a negative effect on illness outcome. Its incidence in patients treated with antipsychotics has shown to be highly variable across studies. OBJECTIVES: Our goals were to investigate prevalence, risk factors for the development of acute akathisia, and differences in incidence between antipsychotics in a sample of 493 first episode non-affective psychosis patients. METHODS: This is a pooled analysis of three prospective, randomized, flexible-dose, and open-label clinical trials. Patients were randomized assigned to different arms of treatment (haloperidol, quetiapine, olanzapine, ziprasidone, risperidone, or aripiprazole). Akathisia was determined using the Barnes Akathisia Scale at 6 weeks after antipsychotic initialization. Univariate analyses were performed to identify demographic, biochemical, substance use, clinical, and treatment-related predictors of acute akathisia. Considering these results, a predictive model based of a subsample of 132 patients was constructed with akathisia as the dependent variable. RESULTS: The overall incidence of akathisia was 19.5%. No differences in demographic, biochemical, substance use, and clinical variables were found. Significant incidence differences between antipsychotics were observed (? 2 = 68.21, p = 0.000): haloperidol (57%), risperidone (20%), aripiprazole (18.2%), ziprasidone (17.2%), olanzapine (3.6%), and quetiapine (3.5%). The predictive model showed that the type of antipsychotic (OR = 21.3, p = 0.000), need for hospitalization (OR = 2.6, p = 0.05), and BPRS total score at baseline (OR = 1.05, p = 0.03) may help to predict akathisia emergence. CONCLUSIONS: Among second generation antipsychotics, only olanzapine and quetiapine should be considered as akathisia-sparing drugs. The type of antipsychotic, having been hospitalized, and a more severe symptomatology at intake seem to predict the development of acute akathisia.

 Fuente: Psychopharmacology (Berl). 2017 Sep;234(17):2563-2570

Editorial: Springer

 Año de publicación: 2017

Nº de páginas: 8

Tipo de publicación: Artículo de Revista

 DOI: 10.1007/s00213-017-4646-1

ISSN: 0033-3158,1432-2072

Url de la publicación: https://dx.doi.org/10.1007/s00213-017-4646-1

Autores/as

JUNCAL RUIZ, MARÍA

MARIA LUZ RAMIREZ BONILLA

GÓMEZ ARNAU, JORGE

ORTIZ GARCÍA DE LA FOZ, VÍCTOR

OBDULIA MARTINEZ GARCIA

NEERGAARD, KARL DAVID

TABARES SEISDEDOS, RAFAEL