Aripiprazole- and Lurasidone-Induced Akathisia: A Case Report and Literature Review

Akathisia is a distressing extrapyramidal symptom of antipsychotic medications, characterized by a subjective feeling of inner restlessness and an objective urge to move. While first-generation antipsychotics are often associated with akathisia, second-generation antipsychotics, including partial dopamine agonists, such as aripiprazole and serotonin-dopamine activity modulators like lurasidone, may also cause akathisia. This report details the case of a 46-year-old male with treatment-resistant depression who developed severe akathisia sequentially during augmentation therapy, first with lurasidone and later with aripiprazole. In both instances, the distressing symptoms resolved completely upon discontinuation of the offending agent. This case is significant as it highlights that even low, introductory doses of these commonly used second-generation antipsychotics can precipitate severe akathisia. It underscores the critical need for vigilant clinical monitoring and prompt intervention to prevent patient distress and ensure appropriate management, particularly in complex cases like treatment-resistant depression.