(2) Did the adverse event appear after the suspected drug was administered? Result of Naranjo Adverse Drug Reaction Probability Scale for Case A and Case B. Drug-Drug-Induced Akathisia: Two Case Reports, Department of Psychiatry, Korle Bu Teaching Hospital, P. O. Our guide offers strategies to help you or your loved one live better with bipolar disorder. Akathisia may appear as a side effect of the long-term use of antipsychotic medications, Lithium, and some other neuroleptic drugs. The akathisia was managed by reducing her olanzapine 10 mg tablet to 5 mg daily and adding benzhexol 5 mg tablet daily (to be taken when needed) to her treatment regimen. Better still, a facility may go a step further in making the above stated activity part of a bundled care or service to patients with mental disorders. Persisting high plasma concentrations of these medications may have accounted for the development of the akathisia and the long duration in resolution of the symptoms, even when the patient was not adherent to her medications. On day 31, she reported for review with complaints of restlessness and frequent urges to pace around. The information underpins the need for health professionals to consider adverse drug-drug interactions as the probable cause of extrapyramidal side effects experienced by patients on antipsychotics. In severe cases, the thought processes of affected patients may become disorganized and their judgment impaired. For more mental health resources, see our National Helpline Database. In 1998, Lane presented a report on the propensity of selective serotonin reuptake inhibitors (SSRIs) to induce akathisia when combined with antipsychotics. A review of the side effect profiles of the medicines prescribed for Case A and Case B shows that they can all cause symptoms of akathisia [13–17]. Testing a narrow version of the self-medication hypothesis, Relationship of neuroleptic-induced akathisia to drug-induced parkinsonism, Serum iron and ferritin in acute neuroleptic akathisia, Is there a rationale for iron supplementation in the treatment of akathisia? Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. A description of the temporal association between Case A’s presentation, treatment, and resolution of akathisia. This report presents two cases of drug-drug-induced akathisia. An important part of coping with akathisia is managing your medication. If you suspect akathisia, it’s important to see your doctor to get an official diagnosis. If you're feeling alone or frustrated about your symptoms, it can also help to confide in a trusted friend or family member. Case B’s presenting complaints were restlessness, tremor, abdominal discomfort, constipation, and weight gain. The obsessive thoughts used to be one of her complaints before being managed and stabilized on risperidone 2 mg tablet daily, and therefore, the obsessive thoughts could be a symptom of a relapse. This report is to create more awareness about psychotropic-antimicrobial-induced akathisia. On discharge, ciprofloxacin 500 mg tablet every 12 hours for 5 days and fluconazole 150 mg capsule once were added to her medications for the treatment of a urinary tract infection. Objective symptoms are mainly seen in the movement of patients and can be classified as repetitive, purposeful, stereotypical, or suppressible. She presented for review on day 28 with complaints of persisting distressing restlessness, weight gain, and stomach upset. 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