Kandra Kalyan
Psychiatry, Southern Illinois University School of Medicine, Springfield, USA.
Cureus. 2025 Sep 19;17(9):e92704. doi: 10.7759/cureus.92704. eCollection 2025 Sep.
Akathisia is a distressing extrapyramidal symptom of antipsychotic medications, characterized by a subjective feeling of inner restlessness and an objective urge to move. While first-generation antipsychotics are often associated with akathisia, second-generation antipsychotics, including partial dopamine agonists, such as aripiprazole and serotonin-dopamine activity modulators like lurasidone, may also cause akathisia. This report details the case of a 46-year-old male with treatment-resistant depression who developed severe akathisia sequentially during augmentation therapy, first with lurasidone and later with aripiprazole. In both instances, the distressing symptoms resolved completely upon discontinuation of the offending agent. This case is significant as it highlights that even low, introductory doses of these commonly used second-generation antipsychotics can precipitate severe akathisia. It underscores the critical need for vigilant clinical monitoring and prompt intervention to prevent patient distress and ensure appropriate management, particularly in complex cases like treatment-resistant depression.
静坐不能是抗精神病药物令人苦恼的锥体外系症状，其特征是主观上感到内心不安以及客观上有活动的冲动。虽然第一代抗精神病药物常与静坐不能相关，但第二代抗精神病药物，包括部分多巴胺激动剂，如阿立哌唑，以及5-羟色胺-多巴胺活性调节剂，如鲁拉西酮，也可能导致静坐不能。本报告详细介绍了一名46岁难治性抑郁症男性患者的病例，该患者在增效治疗过程中先后出现严重静坐不能，先是使用鲁拉西酮，后来使用阿立哌唑。在这两种情况下，停用致病药物后，令人苦恼的症状完全缓解。该病例具有重要意义，因为它突出表明，即使是这些常用第二代抗精神病药物的低剂量起始用药也可能引发严重静坐不能。它强调了进行警惕的临床监测和及时干预的迫切需要，以防止患者痛苦并确保适当管理，特别是在难治性抑郁症等复杂病例中。
