Case Series of Akathisia in Palliative Medicine: Patient Perspective and Efficacy of Procyclidine in Diagnosis and Management.
David Murphy, Senan Maher, Grace Kennedy and 6 others
PMID 39352840WHAT IT FOUND
Palliative patients with antiemetic-induced akathisia described inner restlessness as being locked in or in a glass coffin.
Procyclidine was given, and inciting drugs were stopped or switched; 17 of 19 documented responses were within hours, but this cannot prove procyclidine works.
Key findings
01Palliative care patients with antiemetic-induced akathisia described inner restlessness as feeling locked in, in a glass coffin, or needing to keep moving.
02Procyclidine was used, and the inciting medication was stopped or switched in fifteen cases; 17 of 19 documented responses were within hours.
03Akathisia was recognised late: mean time from starting the inciting medication to onset was 18.1 days, and from onset to diagnosis was 20.9 days.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a small uncontrolled chart review of 20 patients, not a test of treatment. The inciting medication was also stopped or switched in fifteen cases, so relief cannot be assigned to procyclidine alone. The authors say a placebo effect may have contributed after the explanation of treatment. No adverse effects were documented, but procyclidine can cause urinary retention, dry mouth, constipation, cognitive impairment, agitation, or psychosis.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research or authorship. Open access publication was made possible by a donation from the Mayo/Roscommon Hospice Foundation.
The easy way to misread this
Do not read the rapid procyclidine responses as proof it works. This was a small uncontrolled chart review, and in fifteen cases the inciting medication was also stopped or switched, so improvement could be due to stopping or switching that medication or to placebo.