Akatizi

Akatizi

Akatizi, hareketsizce oturamama ile birlikte öznel bir iç huzursuzluk hissi ile karakterize bir hareket bozukluğudur.[1][2][3] Genellikle, bacaklar en belirgin şekilde etkilenir.[4] Etkilenen vücut bölgeleri kıpırdayabilir, ileri geri sallanabilir veya hızlanabilir,[5] bazı kişiler ise sadece vücutlarında huzursuzluk hissedebilir.[4] En şiddetli vakalar saldırganlık, şiddet veya intihar düşünceleriyle sonuçlanabilir.[4]

Antipsikotik ilaçlar, özellikle birinci nesil antipsikotikler, yaygın bir nedendir.[3][5] Bu yan etkiden sorumlu diğer ajanlar arasında seçici serotonin geri alım inhibitörleri, metoklopramid ve reserpin de yer alabilir.[4] Antipsikotiklerin kesilmesiyle de ortaya çıkabilir.[4] Altta yatan mekanizmanın dopamin içerdiğine inanılmaktadır.[4] Teşhis semptomlara dayanır.[4] Huzursuz bacak sendromundan farkı, akatizinin uyku ile ilişkili olmamasıdır.[4]

Tedavi, durum için daha düşük risk taşıyan bir antipsikotik tedavisine geçişi içerebilir.[4] Antidepresan mirtazapin fayda göstermiştir.[1] Difenhidramin, trazodon, benzatropin ve beta blokerlerin yararına dair kesin olmayan kanıtlar vardır.[3][4]

Terim ilk olarak 1901'de fenomeni tanımlayan Çek nöropsikiyatrist Ladislav Haškovec tarafından kullanılmıştır.[6] Yunanca "değil" anlamına gelen a- ve Grekçe: καθίζειν kathízein, "oturmak" veya başka bir deyişle "oturamama" anlamına gelir.[4]

Kaynakça

  1. ^ a b "Treatment of Antipsychotic-Induced Akathisia: Role of Serotonin 5-HT2a Receptor Antagonists". Drugs. 80 (9): 871-882. June 2020. doi:10.1007/s40265-020-01312-0. PMID 32385739. 
  2. ^ Forcen (February 2016). "Antipsychotic-induced akathisia in delirium: A systematic review". Palliative & Supportive Care. 14 (1): 77-84. doi:10.1017/S1478951515000784. PMC 5516628 $2. PMID 26087817. 
  3. ^ a b c Laoutidis (May 2014). "5-HT2A receptor antagonists for the treatment of neuroleptic-induced akathisia: a systematic review and meta-analysis". The International Journal of Neuropsychopharmacology. 17 (5): 823-32. doi:10.1017/S1461145713001417. PMID 24286228. 
  4. ^ a b c d e f g h i j k Lohr (December 2015). "The clinical challenges of akathisia". CNS Spectrums. 20 Suppl 1: 1-14; quiz 15-6. doi:10.1017/S1092852915000838. PMID 26683525. 
  5. ^ a b Thomas (2015). "The Incidence of Akathisia in the Treatment of Schizophrenia with Aripiprazole, Asenapine and Lurasidone: A Meta-Analysis". Current Neuropharmacology. 13 (5): 681-91. doi:10.2174/1570159x13666150115220221. PMC 4761637 $2. PMID 26467415. 
  6. ^ "Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges". Curr Neuropharmacol. 15 (5): 789-798. 2017. doi:10.2174/1570159X14666161208153644. PMC 5771055 $2. PMID 27928948. 

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