Акатизия при применении антипсихотиков третьего поколения: анализ клинических данных и стратегии ведения

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.

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