Which symptom is commonly treated with beta-blockers when it occurs with antipsychotic therapy?

• A. Akathisia
• B. Dystonia
• C. Tardive dyskinesia
• D. Metabolic syndrome

Answer: (A)

Akathisia is the symptom commonly treated with beta-blockers when it occurs with antipsychotic therapy. It manifests as inner restlessness and a strong urge to move, often with constant pacing or fidgeting, usually developing within days to weeks of starting or increasing the antipsychotic. Propranolol and similar beta-blockers help by dampening the sympathetic arousal that accompanies the restlessness, and they can reduce both the subjective urge to move and the observable pacing or fidgeting. This makes it a preferred option specifically for akathisia compared to other motor side effects.

Dystonia, by contrast, is typically treated with anticholinergic agents like benztropine or diphenhydramine to counteract the acute muscle contractions. Tardive dyskinesia is more about long-standing dopamine receptor changes and is approached with VMAT2 inhibitors or, in some cases, adjusting the antipsychotic. Metabolic syndrome is managed through lifestyle changes and metabolic medications, not beta-blockers.