MEDizzy - A 25-year-old man with a diagnosis of paranoid schizophrenia

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Pharmacological treatment

A 25-year-old man with a diagnosis of paranoid schizophrenia has experienced a psychotic relapse. He is hospitalised and started on a new antipsychotic medication. Which of the following adverse events associated with antipsychotics is thought to increase the risk of suicide?

ExplanationIt has been suggested that akathisia often exacerbates psychotic agitation and that the diagnosis should be considered whenever a patient develops impulsive suicidal ideation after a change in neuroleptic treatment. However, in a critical review of the literature, akathisia was not unequivocally linked to suicidal behaviour. The authors noted that the condition causes considerable distress in an already vulnerable group of patients and recommended that new, more rigorous strategies be put in place to prevent it. See Drake & Ehrlich (1985) and Hansen (2001)