Neuoleptic induced akathisia is an unsual state of subjective feeling of tension to move and objective motor restlessness, so frequently results in non-compliance. Several studies have suggested that akathisia is associated with low serum iron but there is no general agreement nowadays. Author investigated whether akathisic patients had lower indices of serum iron status than matched non-akathisic controls by 2 weeks-prospective study.

The subjects were 30 inpatients who were receiving antimycotic medication. Akathisia severity was measured by Chouinard rating scale, then 15 akathisic patients were matched with 15 non-akathisic controls for age, sex, length of illness, duration of treatment, the highest dosage of natipsychotic medication, and use of antiparkinsonian agents. The frequency of acute dystonia and AIMS for other extrapyramidal side effects were examed, also. Venous blood samples of all subjects were analysed for serum Fe, ferritin, TIBC on the 1st, 7th, and 14th medication day.

Sociodemographic factors, such as, sex, mean age, and clinical characteristics such as, length of illness, duration of treatment, the kinds and mean dosage of neuroleptics, were not different between the akathisia and the control group(p>0.05). The akathisic patients had significantly lower level of serum Fe than the control on 14th day(p<0.05), but no significant decrease during the 2 weeks follow-up(p>0.05). The frequency of acute dystonia, and anticholinergic medication were not different between the two groups(p>0.05), but AIMS score was significantly higher in the akathisia group(p<0.05).

Neuroleptic induced akathisia may be related to the low serum Fe. So, this study supports that low serum iron, via dopamine(D2) receptor hypofunction, increases the susceptibility to akathisia on antipsychotic medication.