Brüne M, Bräunig P
Zentrum für Psychiatrie und Psychotherapie der Ruhr-Universität Bochum.
Fortschr Neurol Psychiatr. 1997 Sep;65(9):396-406. doi: 10.1055/s-2007-996344.
The syndrome of akathisia typically consists of a subjective component, e.g. inner restlessness and an urge to move, and observable symptoms such as restless legs and inability to sit still. In most cases akathisia is caused by neuroleptics. There are several subtypes of akathisia according to the time of onset in the course of neuroleptic treatment. In clinical routine extrapyramidal motor disturbances are often underestimated or misinterpreted. As far as akathisia is concerned, differential diagnosis of restlessness or of repetitive movement patterns may be problematic. Non-compliance and impulsive behaviour are regarded as possible complications of akathisia, but systematic investigations are lacking. The pathophysiology of akathisia is not clear, but it probably differs from other pharmacologically induced motor disturbances. If warrantable, the first step in akathisia treatment is dose-reduction of the causing agent. Anticholinergic drugs, benzodiazepines, and beta-receptor blockers may be effective. Clinical assessment and survey of the patient's behaviour, e.g. during occupational therapy and group therapy is important for an early diagnosis of akathisia so that complications may be minimised.
静坐不能综合征通常包括主观成分，如内心不安和活动冲动，以及可观察到的症状，如腿部不安和无法静坐。在大多数情况下，静坐不能由抗精神病药物引起。根据在抗精神病药物治疗过程中的发病时间，静坐不能有几种亚型。在临床实践中，锥体外系运动障碍常常被低估或误解。就静坐不能而言，对不安或重复运动模式的鉴别诊断可能存在问题。不依从和冲动行为被认为是静坐不能的可能并发症，但缺乏系统研究。静坐不能的病理生理学尚不清楚，但可能与其他药物引起的运动障碍不同。如果有必要，静坐不能治疗的第一步是减少致病药物的剂量。抗胆碱能药物、苯二氮䓬类药物和β受体阻滞剂可能有效。对患者行为进行临床评估和调查，例如在职业治疗和团体治疗期间，对于早期诊断静坐不能很重要，这样可以将并发症降至最低。
