Akathisia is sometimes reversible once the causative agent has been identified and discontinued, but in some cases may become permanent.[27] Case reports and small randomized studies suggest benzodiazepines, propranolol, and anticholinergics may help treat acute akathisia, but are much less effective in treating chronic akathisia.[11]Taylor et al. found success in lowering the dose of antipsychotic medication as an initial response to drug-induced akathisia,[17] which should be done gradually, if possible.[11]To minimize the risk of akathisia from antipsychotics, the clinician is advised to be conservative when increasing dosages.[17]
If the patient is experiencing akathisia due to opioid withdrawal, and continuing use of opioids is not viable, drugs typically prescribed for acute idiopathic akathisia can be effective. GABA analogues pregabalin and gabapentin, as well as drugs approved for treating RLS, may also be effective in certain cases.[citation needed]
One study showed vitamin B6 to be effective for the treatment of neuroleptic-induced akathisia.[28]
N-acetylcysteine also showed a positive effect on akathisia in a randomized control trial.[29]
Additional pharmacologic interventions found to have antiakathisia effects (especially for neuroleptic-induced akathisia) include ß-adrenergic antagonists (e.g., propranolol), benzodiazepines (e.g., lorazepam), anticholinergics (e.g., benztropine), and serotonin antagonists (e.g., cyproheptadine) as an alternative.[16]
Trihexyphenidyl has also been prescribed to treat akathisia.
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