Evidence map›Paper›PMID 38869177›Full record

SynthesisSchizophrenia bulletin2026

Comparative Efficacy and Acceptability of Treatment Strategies for Antipsychotic-Induced Akathisia: A Systematic Review and Network Meta-analysis.

Yuki Furukawa, Kota Imai, Yusuke Takahashi, Orestis Efthimiou, Stefan Leucht

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Schizophrenia bulletin, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. The Australian and New Zealand journal of psychiatry · 2026
    Guideline
  2. Article
  3. Real-world comprehensive care of people living with schizophrenia: recommendations across different settings and clinical stages.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026
    Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yuki FurukawaDepartment of Neuropsychiatry, University of Tokyo Hospital, Tokyo, Japan.ORCID 0000-0003-1317-0220
Kota ImaiPharmaceutical Department, University of Tokyo Hospital, Tokyo, Japan.
Yusuke TakahashiDepartment of Neuropsychiatry, University of Tokyo Hospital, Tokyo, Japan.
Orestis EfthimiouInstitute of Primary Health Care (BIHAM), Faculty of Medicine, University of Bern, Bern, Switzerland.ORCID 0000-0002-0955-7572
Stefan LeuchtDepartment of Psychiatry and Psychotherapy, School of Medicine and Health, Technical University of Munich, Munich, Germany.ORCID 0000-0002-4934-4352

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntipsychotics are the treatment of choice for schizophrenia, but they often induce akathisia. However, comparative efficacy of treatment strategies for akathisia remains unclear.

designWe performed a systematic review and network meta-analyses (PROSPERO CRD42023450720). We searched multiple databases on July 24, 2023. We included randomized clinical trials comparing 1 or more treatment strategies for antipsychotic-induced akathisia against each other or control conditions. We included adults with schizophrenia or other psychiatric disorders treated with antipsychotics. The primary outcome was akathisia severity at posttreatment. Secondary outcomes included akathisia response, all-cause dropout, psychotic symptoms, and long-term akathisia severity. We synthesized data in random effects frequentist network meta-analyses and assessed confidence in the evidence using CINeMA.

resultsWe identified 19 trials with 661 randomized participants (mean age 35.9 [standard deviation 12.0]; 36.7% [195 of 532] women). No trials examined dose reduction or switching of antipsychotics. Findings suggested 5-HT2A antagonists (k = 6, n = 108; standardized mean difference [SMD] -1.07 [95% confidence interval, -1.42; -0.71]) and beta-blockers (k = 8, n = 105; SMD -0.46 [-0.85; -0.07]) may improve akathisia severity, but confidence in the evidence was deemed low. We also found that benzodiazepines (k = 2, n = 13; SMD -1.62 [-2.64; -0.59]) and vitamin B6 (k = 3, n = 67; SMD -0.99 [-1.49; -0.50]) might also be beneficial, but confidence in the evidence was very low. Analyses of secondary outcomes did not provide additional insights.

conclusionsOur findings suggest that 5-HT2A antagonists, beta-blockers, and with a lesser certainty, benzodiazepines, and vitamin B6 might improve akathisia. Given the low to very low confidence in the evidence of add-on agents and the absence of evidence of their long-term efficacy, careful consideration of side effects is warranted. These recommendations are extremely preliminary and further trials are needed.

Indexed as

Akathisia, Drug-InducedAntipsychotic AgentsOutcome Assessment, Health CareSchizophreniaHumansNetwork Meta-Analysis as TopicRandomized Controlled Trials as TopicAntipsychotic AgentsAkathisiaantipsychoticnetwork meta-analysisschizophrenia

Identifiers

PMID38869177
PMCPMC12996876

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.