Evaluation of akathisia in patients with schizophrenia, schizoaffective disorder, or bipolar I disorder: a post hoc analysis of pooled data from short- and long-term aripiprazole trials

J Psychopharmacol. 2010 Jul;24(7):1019-29. doi: 10.1177/0269881109348157. Epub 2009 Dec 14.

Abstract

The objective of this article is to assess the clinical characteristics of akathisia in patients with schizophrenia, schizoaffective disorder, or bipolar I disorder receiving aripiprazole, haloperidol, olanzapine, or placebo. We conducted post hoc analyses of pooled safety data from trials in patients with schizophrenia, schizoaffective disorder, and bipolar I disorder. Outcome measures included the incidence of akathisia, time to onset, duration, severity, and discontinuation due to akathisia, concomitant use of benzodiazepines and/or anticholinergics, Barnes Akathisia Rating Scale (BARS) scores, and the correlation between antipsychotic efficacy and akathisia. The results for schizophrenia and schizoaffective disorder were as follows: akathisia in 9% of aripiprazole- and 6% of placebo-treated patients; 12.5% of aripiprazole- versus 24% of haloperidol-treated patients; 11% of aripiprazole- versus 6% of olanzapine-treated patients. Bipolar I disorder: akathisia in 18% of aripiprazole- and 5% of placebo-treated patients. The clinical characteristics of akathisia were similar between each data set, regardless of disease. Akathisia was generally mild-to-moderate in severity. Discontinuation due to akathisia was low in both the schizophrenia trials (aripiprazole 0.3%; placebo 0%; aripiprazole 0.9%; haloperidol 2.3%; aripiprazole 1.2%; olanzapine 0.2%) and the bipolar trials (aripiprazole 2.3%; placebo 0%). Treatment-emergent akathisia was not associated with a poorer clinical response. In conclusion, akathisia with aripiprazole occurred early in treatment, was mild-to-moderate in severity, led to few study discontinuations, and did not compromise therapeutic efficacy.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Aripiprazole
  • Benzodiazepines / adverse effects
  • Benzodiazepines / therapeutic use
  • Bipolar Disorder / complications*
  • Bipolar Disorder / psychology*
  • Double-Blind Method
  • Haloperidol / adverse effects
  • Haloperidol / therapeutic use
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Olanzapine
  • Piperazines / adverse effects*
  • Piperazines / therapeutic use
  • Psychiatric Status Rating Scales
  • Psychomotor Agitation / drug therapy
  • Psychomotor Agitation / psychology*
  • Psychotic Disorders / complications*
  • Psychotic Disorders / psychology*
  • Quinolones / adverse effects*
  • Quinolones / therapeutic use
  • Randomized Controlled Trials as Topic
  • Schizophrenia / complications*
  • Schizophrenic Psychology*
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Hypnotics and Sedatives
  • Piperazines
  • Quinolones
  • Benzodiazepines
  • Aripiprazole
  • Haloperidol
  • Olanzapine