Phänomenologie und Therapie der Neuroleptika-induzierten Akathisie - eine Literaturübersicht

Abstract

The neuroleptic-induced akathisia (NIA) often appears as a side effect of neuroleptic therapy in psychotic individuals. It can accompany or outlive the period of neuroleptic treatment. Besides the objective symptoms of motor restlessness it is especially the subjective symptoms and complaints as inner restlessness, anxiety, and depression, which cause severe annoyance or even torment patients. Exacerbations of disease symptoms treated with neuroleptics can occur. After outlining development of the concept of akathisia and of the knowledge of NIA some relevant findings in the field of NIA, especially in respect to their clinical pictures and their connections to related neuroleptic-induced side effects, are discussed. Development and present stand of treatment of NIA are described. Treatment with betablockers plays a central role. Pathophysiological aspects are touched in context with therapeutical considerations. The current state of knowledge of NIA allows a better understanding of pathophysiology in neuroleptic side effects in general, enables an almost sufficient treatment of NIA with betablockers, demonstrates the necessity of responsible and cautious use of neuroleptics by physicians and the necessity of careful guidance of such patients who are treated with neuroleptics.

Akathisie

“…Bei zunehmender innerer Anspannung ist das Auftreten starker Angst, Reizbarkeit oder Wut, im Extremfall auch eine echte Zunahme der psychotisch bedingten Unruhe beschrieben worden (van Putten, 1975). Die Symptome sind im Sitzen und Stehen am ausgeprägtesten, im Liegen wird dagegen oft eine gewisse Erleichterung wahrgenommen (Fleischhacker et aI., 1989;Seidel, 1989).…”