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Comparative efficacy of akathisia treatments: A network meta-analysis

Published online by Cambridge University Press:  29 April 2024

Luca Gambolò Open the ORCID record for Luca Gambolò [Opens in a new window] ,
Dario Bottignole ,
Marta D’Angelo Open the ORCID record for Marta D’Angelo [Opens in a new window] ,
Lorenzo Bellini  and
Giuseppe Stirparo
Luca Gambolò
Affiliation:
SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma, Italy
Dario Bottignole
Affiliation:
SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma, Italy
Marta D’Angelo*
Affiliation:
SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma, Italy
Lorenzo Bellini
Affiliation:
SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma, Italy
Giuseppe Stirparo
Affiliation:
SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma, Italy
*
Corresponding author: Marta D’Angelo; Email: marta.dangelo17@gmail.com
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Abstract

Objective

Akathisia, a common side effect of psychotropic medications, poses a significant challenge in neuropsychiatry, affecting up to 30% of patients on antipsychotics. Despite its prevalence, akathisia remains poorly understood, with difficulties in diagnosis, patient reporting, and treatment efficacy. This research aimed to shed light on effective interventions to improve akathisia management.

Methods

A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted, encompassing controlled trials in English and Italian languages. Databases, such asPubMed, Scopus, and EMBASE, were searched until July 9, 2023. Treatment effectiveness was assessed using standardized mean differences (SMDs) in post-treatment akathisia scores.

Results

Thirteen studies involving 446 individuals met the inclusion criteria. Benzodiazepines, beta-blockers, and NaSSA demonstrated significant efficacy as compared with placebo. Anticholinergic, anticonvulsant, triptan, and other treatments did not show significant differences. Benzodiazepines ranked highest in P-scores (0.8186), followed by beta-blockers and NaSSA.

Conclusions

Effective management of akathisia is crucial, with benzodiazepines, beta-blockers, and NaSSA offering evidence-based options. Treatment rankings provide guidance for clinicians. Future research should prioritize larger, more robust studies to address limitations associated with small sample sizes and publication bias. This research enhances our understanding of interventions for akathisia, offering promising options to improve patient quality of life and prevent complications related to non-adherence and mismanagement.

Keywords

akathisiaantipsychoticsnetwork meta-analysisextrapyramidal symptoms
Type
Review
Information
CNS Spectrums , First View , pp. 1 - 9
Copyright
© The Author(s), 2024. Published by Cambridge University Press

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