Cyproheptadine Versus Propranolol for the Treatment of Acute Neuroleptic-Induced Akathisia: A Comparative Double-Blind Study

@article{Fischel2001CyproheptadineVP,
  title={Cyproheptadine Versus Propranolol for the Treatment of Acute Neuroleptic-Induced Akathisia: A Comparative Double-Blind Study},
  author={Tsvi Fischel and Haggai Hermesh and Dov Aizenberg and Zvi Zemishlany and Hanan Munitz and Yoav Benjamini and Abraham Weizman},
  journal={Journal of Clinical Psychopharmacology},
  year={2001},
  volume={21},
  pages={612-615}
}
The purpose of this study was to investigate the efficacy of cyproheptadine, an antiserotonergic agent, in the treatment of neuroleptic-induced akathisia (NIA), as compared with propranolol, the current gold standard. In a double-blind trial, 30 patients with schizophrenia and NIA received either cyproheptadine 16 mg/day (N = 18) or propranolol 80 mg/day (N = 12) for 4 days, followed by 3 days without any anti-NIA treatment. The Barnes Akahisia Scale, Simpson-Angus Extrapyramidal Effects Rating… 

Vitamin B6 Versus Mianserin and Placebo in Acute Neuroleptic-induced Akathisia: A Randomized, Double-blind, Controlled Study

The results indicate that high doses of B6 and a low dose of mianserin may be a useful addition to current treatments of NIA and suggests that the pathophysiology of acute NIA is heterogeneous with the various subtypes of acuteNIA responding differently to the various pharmacological approaches.

Trazodone for the Treatment of Neuroleptic-Induced Acute Akathisia: A Placebo-Controlled, Double-Blind, Crossover Study

It is suggested that Trz's property of serotonin 2A postsynaptic receptor antagonism may be its principal mechanism for the improvement of NIA.

Vitamin B6 treatment in acute neuroleptic-induced akathisia: a randomized, double-blind, placebo-controlled study.

Preliminary results indicate that high doses of vitamin B6 may be useful additions to the available treatments for NIA, perhaps due to its combined effects on various neurotransmitter systems.

Efficacy of low-dose mirtazapine in neuroleptic-induced akathisia: A double-blind randomized placebo-controlled pilot study

It is demonstrated that mirtazapine (15 mg/day) is an efficacious and well-tolerated therapeutic option in NIA and marked 5HT2A/2C antagonistic activity of mirtzapine apparently accounts for its anti-NIA activity.

Trazodone as an Alternative Treatment for Neuroleptic-Associated Akathisia

It is suggested that trazodone might be an effective and relatively safe drug in the treatment of neuroleptic-associated akathisia.

Treatment of Neuroleptic-Induced Akathisia With the 5-HT2A Antagonist Trazodone

Trazodone is found to be a beneficial and relatively safe medication for the treatment of antipsychotic medication-induced akathisia and some improvement was noted in symptomatology of anxiety, depression, and psychosis.

The Effectiveness of Intramuscular Biperiden in Acute Akathisia: A Double-Blind, Randomized, Placebo-Controlled Study

The results suggest that intramuscular biperiden should not be considered as a first-line treatment of NIA, and instead Anticholinergics or isotonic saline should be considered.

The 5-HT1D receptor agonist zolmitriptan for neuroleptic-induced akathisia: an open label preliminary study

Zolmitriptan appears to exert significant and rapid beneficial antiakathisic effect, even in chronic and resistant NIA, as well as the role of serotonergic neurotransmission in NIA.
...

References

SHOWING 1-10 OF 25 REFERENCES

Serotonergic agents in the treatment of acute neuroleptic‐induced akathisia: open‐label study of buspirone and mianserin

It seems that the 5-HT1A partial agonist buspirone is of limited value in the treatment of acute neuroleptic-induced akathisia, and in contrast, it appears that low-dose mianserin is therapentically effective in acute neuroLEptic- induced akath isia.

Treatment of neuroleptic-induced akathisia with the 5-HT2 antagonist mianserin

Mianserin at a low dose may be a promising therapeutic option for patients with acute neuroleptic-induced akathisia, as well as by other relevant clinical rating scales.

Cyproheptadine Treatment in Neuroleptic-Induced Akathisia

Cyproheptadine may be useful in neuroleptic-induced akathisia and showed improvement in the severity of akath isia, which in the majority (15/17) was of a marked degree.

Treatment of neuroleptic induced akathisia with the 5-HT2 antagonist ritanserin.

First results of a single-blind trial of ritanserin in the treatment of neuroleptic-induced akathisia are encouraging and warrant further studies.

Lack of efficacy of the 5-HT3 receptor antagonist granisetron in the treatment of acute neuroleptic-induced akathisia.

It seems that the 5-HT3 subtype of serotonergic receptor is not involved in the development of NIA, and 5- HT3 antagonists are ineffective in the serotonin-related pharmacotherapy of Nia.

Propranolol in the treatment of neuroleptic-induced akathisia.

Fourteen patients with neuroleptic-induced akathisia were treated with propranolol in an open trial. All patients demonstrated substantial improvement of their akathisia; nine of the 14 obtained

The Pharmacologic Treatment of Neuroleptic‐Induced Akathisia

The literature regarding the pharmacologic treatment of acute neuroleptic-induced akathisia is critically reviewed, including nine reports of the use of anticholinergic agents, 15 of the Use of β-blocking agents, and six of theUse of benzodiazepines.

Treatment of the serotonin syndrome with cyproheptadine.