By Perminder Sachdev
This quantity offers the 1st finished account of the clinical and medical features of akathisia and similar syndromes equivalent to stressed legs syndrome (RLS), other kinds of motor restlessness, and neuroleptic-induced dysphoria. the main target is on drug-induced akathisia and its quite a few subtypes. the writer explores its dating to the restlessness because of different neurological issues, offers a brand new synthesis of the pathophysiological mechanisms of akathisia, and gives arguments for brand new operational standards for the examine prognosis of drug-induced akathisia. innovations for the size of akathisia also are mentioned, as are therapy ways. The ebook might be quite valuable for psychiatrists, neurologists, and different physicians looking a greater realizing of those disabling syndromes.
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Extra info for Akathisia and Restless Legs
There are some drugs whose abrupt cessation will lead to a syndrome with restlessness as a major feature in the absence of delirium. Withdrawal from heterocyclic antidepressants, neuroleptics and monoamine oxidase inhibitors may produce restlessness (Dilsaver, 1990). Withdrawal from nicotine in dependent individuals results in anxiety, irritability and restlessness that may last for some weeks (West et al, 1989). Opioid withdrawal may produce restlessness due to either nonpurposive nongoal-directed behaviour or activity (complaints, pleas, manipulations) directed at getting the drug (Jaffe, 1989).
Patients could move from states of 'frozen' catatonia to profound restlessness, 16 Introduction often associated with bizarre perceptions, thoughts and emotions. Sacks (1983) provided some excellent descriptions in his book Awakenings. Not only was restlessness a feature of 'epidemic encephalitis' and the states that followed, but many patients developed it after being treated with L-dopa. One of Sacks' patients was described as follows: I found her intensely agitated and akathisic, constantly kicking and crossing her legs, banging her hands, and uttering sudden high-pitched screams....
Is TA the same as chronic akathisia? Do some patients with AA develop chronic akathisia if they continue on the medication, and should they then be diagnosed as having TA? A term, acute persistent akathisia, has been used (Barnes & Braude, 1985) which sits uneasily between AA and TA. Does this term presuppose that AA is of short duration and self-limiting? What is the status of withdrawal akathisia in relation to TA? Many of these questions are only beginning to be addressed (Sachdev, 1994a). Another term that has added to the heterogeneity of the concepts is pseudoakathisia.
Akathisia and Restless Legs by Perminder Sachdev