Propranolol and Other Beta Blockers (Level of Evidence 1-) Propranolol, a nonselective beta-adrenergic antagonist, is the most studied treatment intervention for antipsychotic-induced akathisia.
Smaller studies have also provided evidence that even cardioselective beta-blockers such as metoprolol and nadolol provide benefit in the treatment of akathisia. Nonetheless, propranolol is generally considered the first-line adjunctive medication treatment for antipsychotic-induced akathisia.
In conclusion, the results of this trial suggest that vitamin B6 may be beneficial for ameliorating of antipsychotic-induced akathisia.
A randomized, double-blind, placebo-controlled study reported that the high-dose pyridoxine-treated patients (1200 mg/day administered as 600 mg BID) had improvement in neuroleptic-induced akathisia symptoms within a few days [70] .
A meta-analysis published in JAMA Network Open suggests that mirtazapine, biperiden, and vitamin B6 are the three most effective treatment options for antipsychotic-induced akathisia.
Once akathisia develops, it usually resolves when the causative agent is either discontinued or dosage is decreased. Again, first step strategies include lowering the dose of antipsychotic drug, switching to lower potency FGA, or switching to an SGA other than risperidone and aripiprazole.
Self-help methods include meditation, breathing exercises and talking to friends and family. If restlessness affects your daily life, talk to a doctor for professional help.
The IV injection of diazepam completely ameliorated the subjective restlessness and distress of antipsychotic- induced akathisia in all 18 patients.
Antipsychotics and other common psychoactive medications can cause neuropsychiatric complications such as akathisia. Akathisia is an extrapyramidal symptom characterized by an uncomfortable sensation of internal restlessness and need to move.
Benzodiazepines—Medications such as clonazepam and lorazepam are generally prescribed to treat anxiety, muscle spasms, and insomnia, and can help individuals get more restful sleep.
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