Efficacy of carbamazepine against neuroleptic-induced akathisia in treatment with perospirone: case series.
Neuroleptic-induced akathisia is a distressing side effect of antipsychotics, and it is unmanageable in some cases. The authors report three cases of schizophrenia whose neuroleptic-induced akathisia did not respond to representative anti-akathisia drugs such as beta-adrenergic antagonists, anticholinergic agents, benzodiazepines and antihistaminergics, and they showed a marked improvement of it without worsening of psychotic symptoms during a combination treatment with carbamazepine and perospirone, a serotonin-dopamine antagonist developed in Japan. As the mechanism of current observation, we assumed that carbamazepine affected the pharmacokinetics of perospirone, and change in the proportion of perospirone and its major active metabolite (ID-15036). Further investigations including the monitoring pharmacokinetics of perospirone and ID-15036 under concomitant use of carbamazepine should be carried out to explain the mechanism of the current experience.
Masui
Takuya
T
Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan. masui@med.hokudai.ac.jp
Kusumi
Ichiro
I
Takahashi
Yoshito
Y
Koyama
Tsukasa
T
D000328:Adult; D017109:Akathisia, Drug-Induced / Q000188:drug therapy*; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D054833:Isoindoles; D008297:Male; D012563:Schizophrenia, Paranoid / Q000188:drug therapy; D013844:Thiazoles / Q000009:adverse effects*
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D004338:Drug Combinations; D007211:Indoles; D054833:Isoindoles; D013844:Thiazoles; D002220:Carbamazepine; C065533:perospirone