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The Akathisic Cyclist - An unusual symptomatic treatment

Taubert, Mark ORCID: and Back, Ian 2007. The Akathisic Cyclist - An unusual symptomatic treatment. Presented at: 10th Congress of the European Association for Palliative Care, Budapest, Hungary, 7-9 June 2007.

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A 47 year old woman was admitted to a palliative care unit with anxiety and agitation. She had metastatic carcinoma of the ovary and suffered with episodes of subacute intestinal bowel obstruction, as well as anxiety and depression. Four days prior to admission she began vomiting, associated with mild intestinal colic. On admission, she displayed classic acute akathisia, continuously pacing the corridor, and describing a sense of restlessness only relieved by movement. Pacing continued throughout the night and caused her a lot of distress and discomfort. She continued to show signs of severe restlessness for a further 3 days, with complete resolution after one week. Pacing made her exhausted, and prevented her from sitting down to meals, or enjoying time with relatives. A diagnosis of akathisia was made. A set of exercise pedals was offered to her, and she found that by continuously pedalling in her chair, she was able to relieve the distressing urge to move, whilst still able to watch television, do crossword-puzzles, speak with relatives and eat meals. Three drugs are considered in this case of akathisia: haloperidol, fluoxetine and levomepromazine. We describe the changes we made to her medication in our case-report stopping or substituting the offending drugs. Th introduction of the exercise pedals made a great impact on our patient's quality of life, and gave relief from the distress of her condition. A literature search found no reference to any such non-drug management of akathisia, and yet the benefit for this patient was profound. We suggest that light, repetitive exercises such as treading exercise pedals could make the unpleasant effects of akathisia more bearable in some patients and that this dimple intervention can have a profound effect on a patient's quality of life.

Item Type: Conference or Workshop Item (Poster)
Date Type: Completion
Status: Unpublished
Schools: Medicine
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Last Modified: 09 Nov 2023 02:07

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