No Association between Akathisia or Parkinsonism and Suicidality in treatment-Resistant Schizophrenia

Abstract

Akathisia and drug-induced Parkinsonism have traditionally beenassociated with depression and suicidality based on case study evidence. In this subanalysis, patients with treatment resistant schizophrenia were rated on the Comprehensive Psychopathological Rating Scale, Barnes Akathisia Scale and Simpson–Angus extrapyramidal side-effect scale at two time points (n = 86 at first assessment; n = 67 at secondassessment). At no time point was there any significant relationship between akathisia and depression/suicidality or distress associated with akathisia and Parkinsonism with suicidality. These preliminary findings warrant further investigation.

Keywords

akathisia depression drug-induced Parkinsonism extrapyramidal side-effects schizophrenia suicide

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References

Anand P , Sanjay G (1993) Polypharmacy akathisia and associated suicide attempts . Depression 1: 53–55

Asberg M , Montgomery S A , Perris C , Shalling D , Sedvall G A (1978) A comprehensive psychopathological rating scale . Acta Psychiatr Scand Suppl 271: 5–27

Barnes T (1989) Akathisia rating scale . Br J Psychiatry 54: 572–575

Casey D E (1998) Effects of clozapine therapy in individuals at risk of tardive dyskinesia . J Clin Psychiatry 59: 31–37

Drake R E , Gates C , Cowan C , Whitaker A (1984) Suicide among schizophrenics . J Nerv Ment Dis 172: 613–617

Hansen L (2001) A critical review of akathisia, and its possible association with suicidal behaviour . Hum Psychopharmacol 16: 495–505

Hansen L , Wilkinson D G (2001) Drug induced akathisia, suicidal ideation and its treatment in the elderly . Int J Geriatr Psychiatry 16: 231–233

Lane R M (1998) SSRI-induced extrapyramidal side-effects and akathisia: implications for treatment . J Psychopharmacol 12: 192–214

Linehan M , Armstrong H E , Suarez A , Allmon D , Heard H L (1993) Cognitive-behavioural treatment of chronically para-suicidal borderline patients . Arch Gen Psychiatry 48: 1060–1064

10.

Lipinski J F , Maltya G , Zimmerman P , Pope H G (1989) Fluoxetine induced akathisia . J Clin Psychiatry 50: 339–342

11.

Marsden C D , Tarsy D , Baldessarini R J (1975) Spontaneous and drug-induced movement disorders in psychotic patients. In Benson D F , Blumer D (eds), Psychiatric aspects of neurological diseases, pp. 219–266. Grune and Stratton, New York

12.

Montgomery S A , Asberg M (1979) A new depression rating scale designed to be sensitive to change . Br J Psychiatry 134: 382–389

13.

Muller M J , Himmerich H , Kienzle B , Szegedi A (2003) Differentiating moderate and severe depression using the Montgomery–Asberg depression rating scale (MADRS) . J Affect Disord 77: 255–260

14.

Roy A (1982) Suicide in chronic schizophrenia . Br J Psychiatry 141: 171–177

15.

Sachdev P (1995) The epidemiology of drug-induced akathisia: Part I . Acute akathisia. Schizophr Bull 21: 431–449

16.

Sensky T , Turkington D , Kingdon D , Scott J J , Scott J , Siddle R , O’Carroll M , Barnes T (2000) A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication . Arch Gen Psychiatry 57: 165–172

17.

Simpson G M , Angus J W S (1970) A rating scale for extrapyramidal side effects . Acta Psychiatr Scand 212(Suppl 44): 171–179