Identification of Risk Factors Associated with Aripiprazole-induced Acute Akathisia

Abstract

Akathisia is one of the extrapyramidal side effects induced by antipsychotics, such as aripiprazole (ARP). Although ARP is used widely in the treatment of various psychiatric disorders, such as schizophrenia, mood disorders, and autism spectrum disorders, there is a higher risk of developing akathisia following treatment with ARP than with other second-generation antipsychotics. However, the risk factors for acute akathisia induced by individual antipsychotics, including ARP, have not been fully established. In this study, we retrospectively analyzed the risk factors for the development of acute akathisia in patients treated with ARP. In total, the study included 160 patients who received ARP between April 2010 and March 2017. We found that 16.3% of all patients (n = 26) experienced ARP-induced acute akathisia within 6 weeks of receiving the first dose. There were significant differences in age (P < 0.01), sex (P = 0.04), and diazepam equivalent dose (P < 0.01) between patient groups with and without akathisia. Moreover, multivariate analysis indicated that age (younger than or equal to 31 years of age, P < 0.01) and diazepam equivalent dose (less than or equal to 4.2 mg, P = 0.03) were relevant factors in the development of ARP-induced acute akathisia. The results of this study suggest that scrupulous clinical attention should be paid to younger patients and patients receiving a relatively low diazepam equivalent dose during treatment with ARP to prevent the development of acute akathisia.