Akathisia (antipsychotic-induced)
- Reduce dose or switch antipsychotic if feasible
- Propranolol has the best-established drug role
- Short-term benzodiazepine can help selected patients
- Mirtazapine/5-HT2A blockade is another option
- Antimuscarinics help less unless parkinsonism coexists
- Distinguish akathisia from anxiety/agitation
Use at a glance
- Reduce dose or switch antipsychotic if feasible
Treatment options
- Propranolol has the best-established drug role
- Mirtazapine/5-HT2A blockade is another option
Practical pearls
- Antimuscarinics help less unless parkinsonism coexists
- Distinguish akathisia from anxiety/agitation
Choosing treatment
- Short-term benzodiazepine can help selected patients
Self-check
- What antipsychotic adjustment should be considered for akathisia, if feasible?
Reduce the dose or switch. - Which drug has the best-established role for akathisia?
Propranolol.
Drugs used for this (1)
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