Virtual reality as a treatment for acute antiemetic-induced akathisia

Many patients receiving common antiemetic medications for a variety of complaints ranging from gastroenteritis to headache to surgery experience the distressing extra-pyramidal neuropsychiatric side effect of akathisia due to the dopamine-antagonist mechanism of these drugs. Akathisia involves a persistent restlessness and urge to move, common in those taking antiemetics. Currently, a literature gap exists surrounding how virtual reality (VR) often used for general mental health treatment can be leveraged in a biosensor capacity toward neurotransmitter analysis and balancing among patients experiencing antiemetic-induced akathisia. This review examined the potential benefits of wearable VR technology as a non-pharmacological treatment solution for patients displaying signs of akathisia in an acute setting such as the emergency department. The review concluded with a Python code foundation for two machine learning algorithms for a wearable biosensor to correlate neurochemical fluctuations of dopamine and stress-induced cortisol with VR audiovisual inputs among patients with akathisia stemming from these drugs. Potential obstacles included the risk of invasiveness implicated by administration of neurotransmitter saliva tests among wearers experiencing these stressful symptoms as well as the technical challenge of integrating biosensing capabilities into a virtual reality wearable device.