Severe akathisia causing neuroleptic failure: an indication for lithium therapy in schizophrenia?

Several neuroleptics recurrently failed to ameliorate psychosis in three schizophrenic patients. Failures were caused by recurrent intractable akathisia, unresponsive to diazepam and trihexyphenidyl. Lacking this extrapyramidal side effect, lithium carbonate was tried and proved an effective antipsychotic. It is suggested that in schizophrenic psychosis lithium is a rational therapeutic option in cases of neuroleptic intolerance and failures due to akathisia.