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

Dec 17, 2009Journal of psychopharmacology (Oxford, England)

Restlessness symptoms in people with schizophrenia, schizoaffective disorder, or bipolar I during short- and long-term aripiprazole treatment

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Abstract

Akathisia occurred in 9% of patients treated with aripiprazole for schizophrenia.

The incidence of akathisia was 9% for aripiprazole and 6% for placebo in schizophrenia patients.
In patients treated with haloperidol, 24% experienced akathisia compared to 12.5% with aripiprazole.
For bipolar I disorder, akathisia was observed in 18% of aripiprazole-treated patients versus 5% of placebo-treated patients.
Akathisia was generally mild-to-moderate in severity across different diagnoses.
Discontinuation rates due to akathisia were low, ranging from 0% to 2.3% across various treatments.
Treatment-emergent akathisia did not appear to affect the overall clinical response.

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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.

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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

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