Lack of efficacy of d-propranolol in neuroleptic-induced akathisia.
d-Propranolol lacks clinically significant beta-adrenergic receptor blocking properties, but has the same membrane stabilizing effects as racemic (d,l) propranolol. To assess the role of beta-blockade versus membrane stabilization or other shared nonspecific effects in the therapeutic action of propranolol in neuroleptic-induced akathisia (NIA) we treated 11 patients with NIA in a crossover, double-blind study of d-propranolol versus placebo. Akathisia scores were unchanged after both d-propranolol and placebo. Eight patients were subsequently treated in a nonblind manner with racemic propranolol, with a significant reduction in akathisia scores. These findings suggest that beta-blockade, not membrane stabilization or other shared nonspecific effects, contributes to the efficacy of propranolol in NIA.
Adler
L A
LA
Psychiatry Service, New York DVAMC, NY 10010.
Angrist
B
B
Fritz
P
P
Rotrosen
J
J
Mallya
G
G
Lipinski
J F
JF
D000328:Adult; D017109:Akathisia, Drug-Induced; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001794:Blood Pressure; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use*; D011595:Psychomotor Agitation / Q000188:drug therapy / Q000503:physiopathology
D014150:Antipsychotic Agents; D011433:Propranolol