Abstract

Surprisingly, the association of neuroleptic-induced akathisia and aggressive behavior was not formally recognized until nearly two and one-half decades of antipsychotic prescribing had passed. Using a search of the anglophonic literature, this phenomenon is reviewed. Advances in psychopharmacology have reduced neuroleptic-induced akathisia and hold promise to eliminate it altogether. Nonetheless, important clinical and forensic aspects of neuroleptic-induced akathisia and aggression remain and are explored.

References

1.
Casey
DE
.
Neuroleptic-induced acute extrapyramidal syndrome and tardive dyskinesia
.
Psychiatr Clin No Amer
 0193-953X
1993
;
16
:
589
610
.
2.
Maguire
GA
.
Prolactin elevation with antipsychotic medication: mechanisms of action and clinical consequences
.
J Clin Psychiatry
 0160-6689
2002
;
63
(
suppl 4
):
56
62
.
3.
Caroff
SN
,
Mann
SC
,
Campbell
EC
,
Sullivan
KA
.
Movement disorders associated with atypical antipsychotic drugs
.
J Clin Psychiatry
 0160-6689
2002
;
63
(
suppl 4
):
12
19
.
4.
Gross
EJ
,
Hull
HG
,
Lytton
GJ
,
Hill
JA
,
Piersel
WC
.
Case study of neuroleptic-induced akathisia: important implications for individuals with mental retardation
.
American J Mental Retardation
 0895-8017
1993
;
98
:
151
64
.
5.
Galynker
II
,
Nazarian
D
.
Akathisia as violence
.
J Clin Psychiatry
 0160-6689
1997
;
58
:
31
32
.
6.
Lindemayer
J-P
.
The pathophysiology of agitation
.
J Clin Psychiatry
 0160-6689
2000
;
61
(
Suppl 14
):
5
10
.
7.
Popyurovsky
M
,
Weizman
A
.
Serotonin-based pharmacotherapy for acute neuroleptic-induced akathisia: a new approach to an old problem
.
Br J Psychiatry
 0007-1250
2001
;
179
:
4
8
.
8.
Keckich
WA
.
Neuroleptics: violence as a manifestation of akathisia
.
JAMA
 0098-7484
1978
;
240
:
21
85
.
9.
Schulte
JL
.
Homicide and suicide associated with akathisia and haloperidol
.
Am J Forensic Psychiatry
1985
;
6
(
2
):
3
7
.
10.
Herrera
JN
,
Sramek
JJ
,
Costa
JF
,
Roy
S
,
Heh
CW
,
Nguyen
BN
.
High potency neuroleptics and violence in schizophrenics
.
J Nerv Ment Dis
1988
;
176
:
558
61
.
11.
Crowner
ML
,
Douyon
R
,
Convit
A
,
Gaztanaga
P
,
Volavka
J
,
Bakall
R
.
Akathisia and violence
.
Psychopharmacology Bulletin
1990
;
26
:
115
7
.
12.
Cheung
P
,
Schweitzer
I
,
Crowley
KC
,
Yastrubetskaya
O
,
Tuckwell
V
.
Aggressive behaviour and extrapyradmidal side effects of neuroleptics in schizophrenia
.
International Clinical Psychopharmacology
1996
;
11
:
237
240
.
13.
Raja
M
,
Azzoni
A
,
Lubich
L
.
Aggressive and violent behavior in a population of psychiatric inpatients
.
Social Psychiatry and Psychiatric Epidemiology
1997
;
32
:
428
34
.
14.
Citrome
L
,
Volavka
J
.
Violent patients in the emergency setting
.
Psychiatr Clin No Amer
1999
;
22
:
789
801
.
15.
Lion
J
,
Snyder
W
,
Merrill
G
.
Underreporting of assault on staff in a state hospital
.
Hosp Community Psychiatry
1981
;
32
:
497
8
.
16.
Barnes
TRE
.
A rating scale for drug-induced akathisia
.
Br J Psychiatry
1989
;
154
:
672
6
.
17.
Palmstierna
T
,
Wistedt
B
.
Staff observation aggressive scale, SOAS:presentation and evaluation
.
Acta Psychiatr Scand
1987
;
79
:
657
63
.
18.
Duncan
EJ
,
Adler
LA
,
Stephanides
M
,
Sanfilipo
M
,
Angrist
B
.
Akathisia and exacerbation of psychopathology: a preliminary report
.
Clinical Neuropharmacology
2000
;
23
:
169
73
.
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