Role of mirtazapine in the treatment of antipsychotic-induced akathisia
by
Hieber R, Dellenbaugh T, Nelson LA.
Western Missouri Mental Health Center,
Kansas City, MO, USA.
Ann Pharmacother. 2008 Jun;42(6):841-6.


ABSTRACT

OBJECTIVE: To evaluate the role of mirtazapine in the treatment of antipsychotic-induced akathisia. DATA SOURCES: MEDLINE (1966-February 2008) and PsycINFO (1967-February 2008) were searched using the terms akathisia and mirtazapine. A bibliographic search was conducted as well. STUDY SELECTION AND DATA EXTRACTION: All English-language articles identified from the search were evaluated. All primary literature was included in the review. DATA SYNTHESIS: Antipsychotic-induced akathisia can be difficult to manage and may respond to mirtazapine based on its antagonist activity at the serotonin 5-HT(2A)/5-HT(2C) receptors. Three case reports (N = 9 pts.), 1 placebo-controlled trial (N = 26), and 1 placebo- and propranolol-controlled study (N = 90) that evaluated mirtazapine for antipsychotic-induced akathisia have been published. Mirtazapine demonstrated a response rate of 53.8% compared with a 7.7% response rate for placebo, based on at least a 2-point reduction on the Barnes Akathisia Scale (global subscale; p = 0.004). Using the same criterion, mirtazapine and propranolol demonstrated efficacy based on response rates of 43.3% and 30.0% compared with placebo (6.7%; p = 0.0051). Mirtazapine was better tolerated than propranolol. In both studies, drowsiness was the most common adverse event associated with mirtazapine. CONCLUSIONS: Mirtazapine may be considered a treatment option for antipsychotic-induced akathisia. It may be especially useful for patients with contraindications or intolerability to beta-blockers and for those with comorbid depression or negative symptoms. Additional studies should be conducted to provide further evidence of mirtazapine's effectiveness in treating akathisia.

Akathisia
Mirtazapine
Mirtazapine v SSRIs
Mirtazapine: overview
Mirtazapine and memory
Mirtazapine v imipramine
Mirtazapine: clinical profile
Mirtazapine and depression
Antidepressant mechanisms
Mirtazapine and the receptors
Mirtazapine: pharmacokinetics
Mirtazapine and sexual function
Mirtazapine: adverse side-effects
Mirtazapine (Remeron) /negative symptoms
Dopaminergic and noradrenergic antidepressants
Mirtazapine (Remeron)-induced spontaneous orgasms
How effective are commonly prescribed antidepressants?
Mirtazapine (Remeron) and the serotonin 5-HT2c receptors


Refs
and further reading

HOME
HedWeb
Nootropics
erythroxylum-coca.com
Future Opioids
BLTC Research
MDMA/Ecstasy
Superhapiness?
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Good Drug Guide

The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family