bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2026-2-1096bekhterev-1377Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWАкатизия при применении антипсихотиков третьего поколения: анализ клинических данных и стратегии веденияAkathisia Associated with the Use of Third-Generation Antipsychotics: Clinical Data Analysis and Management Strategieshttps://orcid.org/0000-0003-0878-3452БогачеваВ. А.BogachevaV. A.

Богачева Вероника Андреевна — к.м.н., научный сотрудник отделения интегративной терапии больных нейропсихиатрического профиля (192019 г. Санкт-Петербург, ул. Бехтерева дом 3).

Veronika A. Bogacheva

ronika1988@mail.ruhttps://orcid.org/0000-0003-2266-9197ЗахаровД. В.ZakharovD. V.

Захаров Денис Валерьевич — д.м.н., заведующий отделением интегративной терапии больных нейропсихиатрического профиля

Denis V. Zakharov

zaharov_dv@mail.ruhttps://orcid.org/0000-0002-7700-2704МихайловВ. А.MikhailovV. А.

Михайлов Владимир Алексеевич — д.м.н., научный руководитель отделения интегративной терапии больных нейропсихиатрического профиля

Vladimir А. Mikhailov

vladmikh@yandex.ruНациональный медицинский исследовательский центр психиатрии и неврологии им. В.М. БехтереваРоссияV.M. Bekhterev National Medical Research Centre for Psychiatry and NeurologyRussian Federation202628052026602816Copyright © Богачева В.А., Захаров Д.В., Михайлов В.А., 20262026Богачева В.А., Захаров Д.В., Михайлов В.А.Bogacheva V.A., Zakharov D.V., Mikhailov V.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/1377

Настоящая работа представляет собой нарративный обзор, посвящённый анализу лекарственно-индуцированной акатизии при применении антипсихотиков с частичной агонистической активностью на D2-рецепторах. Цель — анализ частоты и клинических особенностей лекарственно-индуцированной акатизии при применении антипсихотиков третьего поколения, а также обсуждение стратегий её распознавания и коррекции в клинической практике. Материалы и методы: анализ публикаций из баз данных PubMed, Scopus, Web of Science, РИНЦ и eLibrary. Включались работы с ключевыми словами: akathisia, antipsychotics, aripiprazole, brexpiprazole, cariprazine, lurasidone. Исключались статьи без клинических данных. Отдавался приоритет метаанализам и РКИ. Результаты: акатизия остаётся одним из наиболее частых побочных эффектов антипсихотиков. Приём арипипразола, брек-спипразола и карипразина сопровождается акатизией в 5–15% случаев. Луразидон имеет сопоставимый риск. Симптомы чаще легкие или умеренные, тяжёлые формы редки. Эффективность терапевтических стратегий (снижение дозы, замена препарата, β-блокаторы, бензодиазепины) остаётся ограниченной. Заключение: акатизия значительно влияет на приверженность терапии и требует настороженности со стороны клинициста. Диагностика осложняется неспецифичностью жалоб и требует использования валидированных шкал (например, BARS). Необходим индивидуализированный подход и дальнейшие исследования по профилактике и лечению акатизии.

This article is a narrative review focused on the analysis of drug-induced akathisia associated with the use of antipsychotics exhibiting partial agonist activity at D2 receptors. The aim — analysis of the frequency and clinical characteristics of drug-induced akathisia associated with third-generation antipsychotics, and discussion of strategies for its recognition and management in clinical practice. Materials and methods: A literature search was conducted using the PubMed, Scopus, Web of Science, RSCI, and eLibrary databases. Articles containing the following keywords were included: akathisia, antipsychotics, aripiprazole, brexpiprazole, cariprazine, lurasidone. Studies lacking clinical data were excluded. Priority was given to meta-analyses and randomized controlled trials. Results: Akathisia remains one of the most common adverse effects of antipsychotic therapy. Aripiprazole, brexpiprazole, and cariprazine are associated with akathisia in 5–15% of cases. Lurasidone shows a comparable risk. Symptoms are usually mild to moderate, and severe cases are rare. The effectiveness of therapeutic strategies—such as dose reduction, switching drugs, β-blockers, or benzodiazepines—remains limited. Conclusion: Akathisia has a substantial impact on treatment adherence and requires clinical vigilance. Diagnosis is complicated by nonspecific symptoms and necessitates the use of validated rating scales (e.g., BARS). An individualized approach and further research are needed to improve   prevention and management of this condition.

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The authors declare that there are no conflicts of interest present.