Akathisia

Here’s an interesting story from Australia, recently back in the spotlight. From 1962 to 1979, psychiatrist Harry Bailey, MD, serving as chief psychiatrist at Chelmsford Private Hospital in New South Wales, practiced “deep sleep therapy”, which involved keeping people in barbiturate-induced comas for days or even weeks. Twenty-four of the individuals who received this “treatment” died while still in the hospital. Many more died or showed permanent brain damage after discharge. ...

On October 13, an interesting article was published on the Huffington Post Blog. The author is Jessica Gold, MD, a psychiatry resident at Stanford University; the post is titled Inpatient Psychiatry: Not all Needles, Drugs And Locks. The article is a personal experience/opinion piece, the gist of which is that people who criticize or condemn psychiatry simply don’t understand the complexities and needs of psychiatry’s “patients”, particularly the need for locked wards. ...

Thirty-three years ago, in August 1983, an article titled Suicide Associated with Akathisia and Depot Fluphenazine Treatment appeared in the Journal of Clinical Psychopharmacology. The authors were Katherine Shear, MD, Allen Frances, MD, and Peter Weiden, MD. Here are some quotes, interspersed with my comments/observations: "Akathisia is a common and distressing side effect of neuroleptic medication that can be difficult to recognize and treat. Several previous reports mention maladaptive behavioral consequences, such as poor compliance with prescribed medication and aggressive or self-destructive outbursts. We are reporting suicides in two young Hispanic men who had developed severe akathisia after treatment with depot fluphenazine. Depression with suicidal behavior has been observed following fluphenazine injection, but suicide associated with akathisia has not been previously noted." ...

There’s an interesting February 11, 2014, article on Peter Breggin’s website: $1.5 Million Award in Child Tardive Dyskinesia Malpractice. Thanks to Mad in America for the link. Here’s the opening paragraph: "On February 11, 2014 a Chicago jury awarded $1.5 million to an autistic child who developed a severe case of tardive dyskinesia and tardive akathisia while being treated by psychiatrists with Risperdal and then Zyprexa between 2002 and 2007. The drug-induced disorder was diagnosed when he was fifteen years old and by then had become disabling and irreversible." ...

Melissa, a commenter on a recent post, asked if I would do a post on akathisia. Akathisia literally means inability to sit. People with this problem typically pace for long periods, and if they do sit down, they continue to keep moving and shifting their position in the chair. In severity it can range from a generalized sense of uneasiness or agitation, to severe discomfort and even pain. The discomfort tends to be located in the legs, but can also occur in the hip and pelvic area. In severe cases, the victims pace to the point of exhaustion, but even then sitting does not relieve the discomfort. ...