title: Amisulpride-induced acute akathisia in OCD: an example of dysfunctional dopamine-serotonin interactions?
abstract: We report about a clinical observation in a well-characterized group of patients with obsessive-compulsive disorder (OCD) during an experimental medicine study in which a single dose of amisulpride (a selective D₂/₃ antagonist) was administered. Almost half of the OCD patients, in particular those with less severe obsessive-compulsive symptoms, experienced acute akathisia in response to the amisulpride challenge. This unexpectedly high incidence of akathisia in the selective serotonin reuptake inhibitor (SSRI)-treated patients with OCD suggests that individual differences in dopamine-serotonin interactions underlie the clinical heterogeneity of OCD, and may thus explain the insufficiency of SSRI monotherapy in those patients not experiencing a satisfactory outcome in symptom reduction. We further speculate about the neuropathology possibly underlying this clinical observation and outline a testable hypothesis for future molecular imaging studies.
authors: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK. ke220@cam.ac.uk
authors: Karen D
authors: KD
authors: Ersche
authors: Paul
authors: P
authors: Cumming
authors: Kevin J
authors: KJ
authors: Craig
authors: Ulrich
authors: U
authors: Müller
authors: Naomi A
authors: NA
authors: Fineberg
authors: Edward T
authors: ET
authors: Bullmore
authors: Trevor W
authors: TW
authors: Robbins
mesh_terms: D000328:Adult; D017109:Akathisia, Drug-Induced / Q000209:etiology* / Q000378:metabolism; D000077582:Amisulpride; D004298:Dopamine / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000378:metabolism; D012701:Serotonin / Q000378:metabolism*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013469:Sulpiride / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000077582:Amisulpride; D004298:Dopamine; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors; D013469:Sulpiride