Treatment of Akathisia by Propranolol

A condition of motor restlessness ranging from a feeling of inner disquiet to inability to sit or lie quietly or to sleep.Called also acathisia, akithisia, and Kathisiophobia (1). The term ''Akathisia" was created by Haskovec in 1901. Haase first applied the term (1955) to the inability to sit still and to the other irri­tative hyperkinetic symptoms that are sometimes seen as a complication of pheno­thiazine or reserpine therapy. At present time this term refers almost exclu­sively to a side effect of neuroleptic drugs, often the symptom is of such inten­sity that it becomes impossible for the patients to sit still day or night and is described by them as more difficult to endure than any of symptoms for which they had been treated. Akathisia is overlooked frequently as a concomitant of early neuroleptic therapy. The frequence of neuroleptic induced akathisia ranges from 5% to 45%  (and in some reports 50%) 20% seems to be the most common estimate.Acquaintance with this symptom of akathisia which persists for a consider - able time after the drug has been withdrawn is important because it is some times mistaken for agitated depression and wrongly treated e.g. with electroconvulsive therapy (ECT) or with increasing phenothiazine drugs. The treatment of akathisia is difficult. Although anticholinergic drugs , amantadine and benzodiazepines are effective in some cases, they are most often  of limited benefit. Recently Beta-blockers were found to be effective in the treatment of neuro­leptic-induced akathisia proposed with a central Beta-blocker mechanism of action  (Lipophilic) with higher affinity for Beta l(Beta One) than Beta 2 adrenoceptors.  In the present study the author reviews the papers reported on this subject and evaluates the effects of aforementioned drugs with good result of lipophilic Beta-blocker drugs (propranolol) in the treatment of neuroleptic induced akathi­sia of Iranian patients in a psychiatric hospital.