Gambolò Luca, Bottignole Dario, D'Angelo Marta, Bellini Lorenzo, Stirparo Giuseppe
SIMED (Società Italiana di Medicina e Divulgazione Scientifica), Parma, Italy.
CNS Spectr. 2024 Aug;29(4):243-251. doi: 10.1017/S1092852924000233. Epub 2024 Apr 29.
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.
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.
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 -scores (0.8186), followed by beta-blockers and NaSSA.
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.
静坐不能是精神药物常见的副作用，在神经精神病学领域构成重大挑战，高达30%的抗精神病药物治疗患者会受到影响。尽管其普遍存在，但静坐不能仍未得到充分理解，在诊断、患者报告和治疗效果方面存在困难。本研究旨在阐明改善静坐不能管理的有效干预措施。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行系统评价，纳入英文和意大利文的对照试验。检索了诸如PubMed、Scopus和EMBASE等数据库，检索截止至2023年7月9日。使用治疗后静坐不能评分的标准化平均差（SMD）评估治疗效果。
13项涉及446名个体的研究符合纳入标准。与安慰剂相比，苯二氮䓬类药物、β受体阻滞剂和去甲肾上腺素能和特异性5-羟色胺能抗抑郁药（NaSSA）显示出显著疗效。抗胆碱能药物、抗惊厥药物、曲坦类药物和其他治疗方法未显示出显著差异。苯二氮䓬类药物的SMD得分最高（0.8186），其次是β受体阻滞剂和NaSSA。
有效管理静坐不能至关重要，苯二氮䓬类药物、β受体阻滞剂和NaSSA提供了基于证据的选择。治疗排名为临床医生提供了指导。未来的研究应优先进行更大规模、更有力的研究，以解决与小样本量和发表偏倚相关的局限性。本研究增进了我们对静坐不能干预措施的理解，提供了有前景的选择，以改善患者生活质量并预防与不依从和管理不善相关的并发症。
