Akathisia Associated with the Use of Third-Generation Antipsychotics: Clinical Data Analysis and Management Strategies
https://doi.org/10.31363/2313-7053-2026-2-1096
Abstract
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.
About the Authors
V. A. Bogacheva
V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology
Russian Federation
Russian Federation
Veronika A. Bogacheva
D. V. Zakharov
V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology
Russian Federation
Russian Federation
Denis V. Zakharov
V. А. Mikhailov
V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology
Russian Federation
Russian Federation
Vladimir А. Mikhailov
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Bogacheva V.A., Zakharov D.V., Mikhailov V.А. Akathisia Associated with the Use of Third-Generation Antipsychotics: Clinical Data Analysis and Management Strategies. V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY. 2026;60(2):8-16. (In Russ.) https://doi.org/10.31363/2313-7053-2026-2-1096
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