akathasia and antipsychotics in autism
Among antipsychotics, the adverse effect most commonly perceived as "increased physical activity" is akathisia , a syndrome of inner restlessness accompanied by pacing, inability to sit still, constant leg movements, rocking, or repetitive walking. It can easily be mistaken for hyperactivity, worsening ADHD, agitation, or behavioral deterioration. The antipsychotics with the highest propensity to cause akathisia are: High risk Moderate risk Low risk Haloperidol Risperidone Clozapine Fluphenazine Lurasidone Quetiapine Trifluoperazine Ziprasidone Olanzapine Aripiprazole* Paliperidone Chlorpromazine Brexpiprazole* (less than aripiprazole) Cariprazine* *Partial dopamine agonists (aripiprazole, brexpiprazole, cariprazine) are particularly associated with subjective restlessness despite being second-generation antipsychotics. In children with autism or developmental disorders, akathisia may present as: Increased pacing or wandering Constant...