Antipsychotic polytherapy might be associated with a higher risk of akathisia among patients with schizophrenia, according to a study published by Dr. Fabrice Berna of the University Hospital of Strasbourg (France) and his colleagues with the FondaMental Academic Centers of Expertise for Schizophrenia group.
Researchers followed 372 community-dwelling patients with schizophrenia (n = 291) or schizoaffective disorder (n = 81) and measured akathisia using the 6-point Barnes Akathisia Scale (BAS).
The global prevalence of akathisia (defined by a score of 2 or higher on the BAS) among these patients was 18.5% (58 of 372). Polytherapy with two first-generation antipsychotics was associated with a twofold increase of akathisia, compared with monotherapy with a first-generation antipsychotic (21.4% vs. 40%). Polytherapy with two second-generation antipsychotics was associated with a threefold increase of akathisia, compared with monotherapy with a second-generation antipsychotic (10.9% vs. 34.2%). Polytherapy with a first- and second-generation antipsychotic was associated with an akathisia prevalence of 14.7%.
“Our results indicate that antipsychotic polytherapy should be at best avoided and suggest that monotherapy should be recommended in cases of akathisia,” the authors wrote. “Long-term administration of benzodiazepines or anticholinergic drugs does not seem to be advisable in cases of akathisia, given the potential side effects of these medications.”
Read the article in Schizophrenia Research (doi: 10/1016/j/schres.2015.10/040).