Sachdev P
Neuropsychiatric Institute, Prince Henry Hospital, Matraville, NSW, Australia.
Schizophr Bull. 1995;21(3):431-49. doi: 10.1093/schbul/21.3.431.
This article reviews the epidemiological data on drug-induced acute akathisia, examining studies in which akathisia was the primary focus as well as those in which it was one of a number of drug side effects studied. The studies are diverse in methodology and suffer from many limitations. Incidence rates for acute akathisia with conventional neuroleptics vary from 8 to 76 percent, with 20 to 30 percent being a conservative estimate; preliminary evidence suggests that the newer atypical antipsychotic drugs are less likely to produce acute akathisia. A number of nonneuroleptic drugs--in particular the serotonin-specific reuptake inhibitors--have been implicated in the development of akathisia, but the epidemiological data are limited. Risk factors for neuroleptic-induced akathisia are not completely understood. Drug dose, rate of increment of dose, and drug potency seem to be important, but the role of sociodemographic factors and other treatment-related variables is modest. Drug-induced parkinsonism is significantly correlated with akathisia. Evidence for iron deficiency as a risk factor is conflicting, and its contribution is likely to be minor.
本文回顾了药物性急性静坐不能的流行病学数据，研究了以静坐不能为主要关注点的研究以及将其作为所研究的多种药物副作用之一的研究。这些研究方法多样，且存在许多局限性。使用传统抗精神病药物时急性静坐不能的发生率从8%至76%不等，保守估计为20%至30%；初步证据表明，新型非典型抗精神病药物引发急性静坐不能的可能性较小。一些非抗精神病药物——尤其是5-羟色胺特异性再摄取抑制剂——与静坐不能的发生有关，但流行病学数据有限。抗精神病药物所致静坐不能的危险因素尚未完全明确。药物剂量、剂量增加速率和药物效价似乎很重要，但社会人口统计学因素及其他与治疗相关变量的作用不大。药物性帕金森症与静坐不能显著相关。缺铁作为危险因素的证据存在矛盾，其作用可能较小。
