Download PDF
Pharmacopsychiatry 2012; 45(07): 292-296
DOI: 10.1055/s-0032-1309004
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

The Relationship of Akathisia with Treatment Emergent Suicidality among Patients with First-Episode Schizophrenia Treated with Haloperidol or Risperidone

F. Seemüller   *
1   Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
,
U. Lewitzka   *
2    Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
3    Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
,
M. Bauer
2    Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
,
S. Meyer
1   Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
,
R. Musil
1   Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
,
R. Schennach
1   Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
,
M. Riedel
1   Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
4    Department of Psychiatry and Psychotherapy, Vinzenz von Paul Hospital, Rottweil, Germany
,
S. Doucette
3    Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
,
H.-J. Möller
1   Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
› Author Affiliations
Further Information

Publication History

received 18 October 2011
revised 20 February 2012

accepted 06 March 2012

Publication Date:
21 May 2012 (online)

Also available at
    Permissions and Reprints

Abstract

Akathisia as well as younger age, early illness onset and discharge are important risk factors for suicidality in patients with first-episode schizophrenia. The aim of the present study was to analyze on a single case basis the relationship between a sudden increase in suicidality, anxiety symptoms, medication dosing and clinician- and patient-rated akathisia. A small subsample of patients demonstrated a positive relationship between suicidality and akathisia scores within the titration period of the study medication.

Key words

akathisia - anxiety - first episode schizophrenia - suicidality
*

*  Both authors contributed equally.


 

  • References

  • 1 van Putten T. The many faces of akathisia. Compr Psychiatry 1975; 16: 43-47
    CrossrefPubMedGoogle Scholar
  • 2 Falkai P, Wobrock T, Lieberman J et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, Part 1: acute treatment of schizophrenia. World J Biol Psychiatry 2005; 6: 132-191
    Google Scholar
  • 3 Gaebel W, Riesbeck M, Wölver W et al. German Study Group on First-Episode Schizophrenia . Maintenance treatment with risperidone or low-dose haloperidol in first-episode schizophrenia: 1-year results of a randomized controlled trial within the German Research Networt on Schizophrenia. J Clin Psychiatry 2007; 68: 1763-1774
    Google Scholar
  • 4 Girgis RR, Phillips MR, Li X et al. Clozapine v. chlorpromazine in treatment-naïve, first-episode schizophrenia: 9-year outcomes of a randomised clinical trial. Br J Psychiatry 2011; 199: 281-288
    CrossrefPubMedGoogle Scholar
  • 5 Hawton K, Sutton L, Haw C et al. Schizophrenia and suicide: systematic review of risk factors. Br J Psychiatry 2005; 187: 9-20
    CrossrefPubMedGoogle Scholar
  • 6 Hansen L. A critical review of akathisia – and its possible association with suicidal behaviour. Human Psychopharmacology 2001; 16: 495-505
    CrossrefPubMedGoogle Scholar
  • 7 Seemüller F, Schennach R, Mayr A et al. Riedel M for the German Study Group on First-Episode Schizophrenia . Akathisia and suicidal ideation in first episode schizophrenia (FES). J Clin Psychopharmacol submitted
    PubMedGoogle Scholar
  • 8 Möller HJ, Riedel M, Jäger M et al. Short-term treatment with Risperidone or Haloperidol in first-episode schizophrenia: 8-week results of a randomized controlled trial within the German Research Network on Schizophrenia. Int J Neuropsychopharmacol 2008; 11: 985-997
    PubMedGoogle Scholar
  • 9 Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bull 1987; 13: 261-276
    CrossrefPubMedGoogle Scholar
  • 10 Hamilton M. A rating scale for depression. J Neurol, Neurosurg Psychiatry 1960; 23: 56-62
    CrossrefPubMedGoogle Scholar
  • 11 Guy W. National Institut for Mental Health. Clinical Global Impressions. In: Guy W. (ed.). ECDEU assessment manual for psychopharmacology. Rev. edn. Rockville, MD: Institute of Mental Health; 1976. 217-222
    Google Scholar
  • 12 Frances A, Pincus HA, First MB. The Global Assessment of Functioning Scale (GAF). Diagnostic and Statistical Manual of Mental Disorders- IV. Washington DC: American Psychiatric Association; 1994
    Google Scholar
  • 13 APA . Diagnostic and Statistical Manual of Mental Disorders. 4 th edn. Washington DC: American Psychiatric Association; 1994
    Google Scholar
  • 14 Fleischhacker WW, Bergmann KJ, Perovich R et al. The Hillside Akathisia Scale: a new rating instrument for neuroleptic-induced akathisia. Psychopharmacol Bull 1989; 25: 222-226
    PubMedGoogle Scholar
  • 15 Fava M, Rush AJ, Alpert JE et al. Difference in treatment outcome in outpatients with anxious versus nonanxious depression: a STAR*D report. Am J Psychiatry 2008; 165: 342-351
    CrossrefPubMedGoogle Scholar
  • 16 Atbaşoğlu EC, Schultz SK, Andreasen NC. The relationship of akathisia with suicidality and depersonalization among patients with schizophrenia. J Neuropsychiatry Clin Neurosci 2001; 13: 336-341
    CrossrefPubMedGoogle Scholar
  • 17 Kane JM, Fleischhacker WW, Hansen L et al. Akathisia: an updated review focussing on second-generation antipsychotics. J Clin Psychiatry 2009; 70: 627-643
    CrossrefPubMedGoogle Scholar