A Rating Scale for Drug-Induced Akathisia

  title={A Rating Scale for Drug-Induced Akathisia},
  author={Thomas R. E. Barnes},
  journal={British Journal of Psychiatry},
  pages={672 - 676}
  • T. Barnes
  • Published 1 May 1989
  • Psychology
  • British Journal of Psychiatry
A rating scale for drug-induced akathisia has been derived that incorporates diagnostic criteria for pseudoakathisia, and mild, moderate, and severe akathisia. It comprises items for rating the observable, restless movements which characterise the condition, the subjective awareness of restlessness, and any distress associated with the akathisia. In addition, there is an item for rating global severity. A standard examination procedure is recommended. The inter-rater reliability for the scale… 

The Barnes Akathisia Rating Scale–Revisited

  • T. Barnes
  • Psychology, Medicine
    Journal of psychopharmacology
  • 2003
This review focuses on the signs and symptoms of the condition, and its diagnosis and assessment using the Barnes Akathisia Rating Scale, which was generated 15 years ago and was derived from the findings of studies exploring the clinical features of antipsychotic-induced akathisIA.

Subjective emotional experience and cognitive impairment in drug-induced akathisia.

It is suggested that akathisia is significantly associated with depressive symptoms and attentional impairment, which reflects the complex nature of akath isia that includes motor, emotional, and cognitive aspects.

Metric characteristics of the drug‐induced extrapyramidal symptoms scale (DIEPSS): A practical combined rating scale for drug‐induced movement disorders

The metric properties of the Drug‐Induced Extrapyramidal Symptoms Scale were examined and results suggest that the DIEPSS is a reliable and valid multidimensional rating scale.

Acute nocturnal akathisia induced by clozapine.

Akathisia, a subjective complaint of restlessness accompanied by observed movements of the legs, is one of the most disagreeable extrapyramidal side effects of medications and often causes noncompliance in patients with schizophrenia.

Acute akathisia and sodium valproate

  • F. Clos
  • Psychology, Medicine
    International journal of psychiatry in clinical practice
  • 2001
A 38-year-old woman who suffers from bipolar affective disorder and developed acute akathisia following the introduction of sodium valproate as a mood stabilizer appears likely to have been affected by a sodium-valproate-induced functional dopaminergic antagonism.

Drug-induced Extrapyramidal Symptoms Scale (DIEPSS) Serbian Language version: Inter-rater and Test-retest Reliability

The Serbian version of DIEPSS has high level of inter-rater and test-retest reliability, and high values of concordance rates (ICC > 0.7) for each evaluated individual item suggest that items of DiePSS are well defined.

A Brief Overview of Iatrogenic Akathisia

Although its pathophysiology is not well-established, a decrease in dopaminergic activity appears to be an important etiological factor and the most effective treatment of akathisia includes administration of either a beta-adrenergic antagonist or a serotonergic 5HT2 receptor antagonist.

Treatment of Neuroleptic-Induced Akathisia With the 5-HT2A Antagonist Trazodone

Trazodone is found to be a beneficial and relatively safe medication for the treatment of antipsychotic medication-induced akathisia and some improvement was noted in symptomatology of anxiety, depression, and psychosis.

Phenomenology and Prevalence of Neuroleptic-Induced Akathisia in Late Life.

  • R. SweetB. Mulsant G. Zubenko
  • Psychology, Medicine
    The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
  • 1993
Objective evidence of akathisia was strongly associated with current neuroleptic use and the presence of MA was associated with a lower rate of antiparkinsonian agent use.

Treatment of tardive akathisia with clonidine: a case report.

A retrospective analysis of clinical features and therapeutic trials for tardive akathisia showed that almost all of the 52 cases developed this chronic form after an average of 4.5 yr following neuroleptic drug initiation, 34% even within 1 yr.



Clinical Characteristics of Akathisia

Assessment of drug-induced movement disorders was carried out regularly on 104 psychiatric patients requiring antipsychotic medication on admission to hospital, suggesting two distinct types of acute akathisia; one related to severe parkinsonism and one not.

The many faces of akathisia.


A modification of an earlier rating scale for extrapyramidal system disturbance is described, and evidence for the validity and reliability of the scale is presented. The usefulness of the scale in

Akathisia variants and tardive dyskinesia.

The findings suggested a possible relationship between pseudoakathisia, orofacial and limb dyskinesia, and the severity of negative schizophrenic symptoms.

Toward a more reliable diagnosis of akathisia.

It is argued that "general com plaints of emotional unease" or "inner restlessness" are too nonspecific for a diagnosis of akathisia, and Barnes and Braude have added the more observable criterion for restless leg movements.

Behavioral toxicity of antipsychotic drugs.

Akathisia is strongly associated with depression and dysphoric responses to neuroleptics and has even been linked to suicidal and homicidal behavior in extreme cases.

Neuroleptics. Violence as a manifestation of akathisia.

To my knowledge, however, the literature does not contain reports that the development of akathisia can precipitate violence, resulting in the behavior the drug was meant to alleviate.

Effect of clorazepate on depressed mood in anxious patients.

Clorazepate-treated patients with concomitant high levels of depressed mood showed significant improvement of anxiety symptomatology, as measured by the Hamilton Rating Scale for Anxiety and the Zung Self-Rating Anxiety Scale, and of depression mood, as measures by the SDS, compared with placebo- treated patients.

Clinical nonrecognition of neuroleptic-induced movement disorders: a cautionary study.

A high rate of clinical underrecognition is found of all major extrapyramidal syndromes, especially tardive dyskinesia, which is a major limitation in the use of neuroleptics and is recommended for improved training in their detection.