Treatment of neuroleptic-induced akathisia with the 5-HT2 antagonist mianserin. Double-blind, placebo-controlled study.
BACKGROUND
Serotonin (5-HT):dopamine imbalance may underlie neuroleptic-induced akathisia.


OBJECTIVE
To evaluate the efficacy of the 5-HT2 antagonist, mianserin in neuroleptic-induced akathisia.


METHODS
Thirty neuroleptic-treated patients with schizophrenia were randomly allocated in a double-blind design to receive either mianserin (15 mg/day) or placebo for five days. Patients were assessed at baseline and on Days 3 and 5 by the Barnes Akathisia Scale (BARS), as well as by other relevant clinical rating scales.


RESULTS
Compared with the placebo group, the mianserin-treated patients showed a significant reduction in all four BARS subscales by Day 5, with mean reductions in the BARS global score of 9.9% and 52.2%, respectively (P = 0.006). Response to treatment (a reduction of at least two points on the BARS global subscale), was noted in six patients (40%) in the mianserin group and only one patient (9.1%) in the placebo group (P = 0.04, log odds ratio 2.23).


CONCLUSIONS
Mianserin at a low dose may be a promising therapeutic option for patients with acute neuroleptic-induced akathisia.
Poyurovsky
M
M
Research Unit, Tirat Carmel Mental Health Center, Israel.
Shardorodsky
M
M
Fuchs
C
C
Schneidman
M
M
Weizman
A
A
D000328:Adult; D017109:Akathisia, Drug-Induced / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008803:Mianserin / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy; D012702:Serotonin Antagonists / Q000627:therapeutic use*; D016896:Treatment Outcome
D012702:Serotonin Antagonists; D008803:Mianserin