Akathisia (Restless Legs Syndrome) in People With Schizophrenia and Mental Retardation
Condition: Akathisia
MeSH terms: Psychomotor Agitation
Study type: Observational

Summary: 
      Akathisia is a movement disorder that is often a side effect of certain psychiatric drugs.
      People with akathisia are unable to sit or keep still, complain of restlessness, fidget, rock
      from foot to foot, and pace. Akathisia is sometimes called "restless legs syndrome." The
      drugs that can cause akathisia are most often used to treat patients with schizophrenia or
      mental retardation (MR). This study will evaluate akathisia in both schizophrenic and MR
      patients who either have long-term akathisia or who are starting treatment with psychiatric
      drugs.
    

Detailed description: 
      Akathisia is a relatively common side effect of neuroleptic medication that occurs within 1
      week to 6 months after the initiation of medication. Akathisia is characterized by a variety
      of movement manifestations, such as fidgeting, irritability, inability to sit or stand still,
      marching in place, continuous trunk motions, sleeplessness, and a subjective sense of
      restlessness. Akathisia has been studied primarily in schizophrenic patients, although
      reports on individuals with mental retardation suggest that akathisia also occurs in this
      population. This study will characterize the movement dynamics of akathisia in schizophrenic
      and mentally retarded adults using two experimental series.

      The first experimental series will compare chronic akathisia in schizophrenic and MR
      patients. Four groups of MR patients and four groups of schizophrenic patients will be
      studied: young (age 18 to 38) with chronic akathisia, older (age 40 to 60) with chronic
      akathisia, young on neuroleptics without akathisia, and older on neuroleptics without
      akathisia. Two control groups will include healthy individuals with normal intelligence who
      are not on neuroleptic medication. Assessments will include videotaped recordings and
      kinematic analysis of naturally occurring akathisia restlessness movements as well as
      cognitive and psychiatric tests. Demographic factors (age and sex) and medication factors
      (type and duration) will also be assessed to determine their relation to and possible impact
      on chronic akathisia.

      The second experimental series will compare schizophrenic and MR patients who are initiating
      neuroleptic therapy. Institutionalized MR patients will be age matched with schizophrenic
      patients. Tests will occur at baseline (prior to drug initiation) and at Weeks 1, 2, 4, 8,
      16, 24, and 52. Those who enroll in the protocol early will be tested for more than 12 months
      where possible and useful. The same analyses as in the first experimental series will be used
      to allow for comparison of acute and chronic akathisia.
    

Observational model: Defined Population
Time perspective: Prospective
Keywords: Akathisia; Mental retardation; Schizophrenia; Neuroleptic medication; Tardive dyskinesia; Brief Psychiatric Rating Scale; Barnes test; Stereotypy Checklist Test; DISCUS Tardive Dyskinesia test