title: Differential sensitivities to risperidone and olanzapine in a human immunodeficiency virus patient.
abstract: BACKGROUND
  Neuroleptic sensitivity presents a considerable problem for the treatment of psychosis in the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV)-positive patient population. As yet, there are few data on the response of these patients to newer atypical antipsychotic medications.
  
  
  METHODS
  We present the detailed medication history of a 33-year-old man with AIDS, who had a prior history of extrapyramidal symptoms (EPS) with both typical antipsychotics and risperidone, and was treated with olanzapine for major depression with psychotic features.
  
  
  RESULTS
  The patient developed akathisia in a dose-dependent manner at dosages between 10 and 15 mg daily of olanzapine, but no EPS. Akathisia responded to dose reduction and use of beta-adrenergic blockade.
  
  
  CONCLUSIONS
  The AIDS patient may exhibit sensitivity even to newer atypical antipsychotics. The lack of EPS and response to a beta-blocker underscore the different mechanisms causing akathisia and EPS.
authors.affiliation: USC Department of Psychiatry, Los Angeles County-USC Medical Center 90033, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Meyer
authors.forename: J
authors.initials: J
authors.lastname: Marsh
authors.forename: G
authors.initials: G
authors.lastname: Simpson
mesh_terms: D000328:Adult; D017109:Akathisia, Drug-Induced / Q000503:physiopathology; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines; D004305:Dose-Response Relationship, Drug; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010890:Pirenzepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D018967:Risperidone; D000077152:Olanzapine