Efficacy of Low-Dose Metoprolol in Neuroleptic-Induced Akathisia

Kim, J.; Adler, Lenard A.; Angrist, Burt; Rotrosen, John

doi:10.1097/00132586-199008000-00056

Cited by 2 publications

(2 citation statements)

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“…Case reports (reviewed in reference 14) and small randomized studies (44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54) suggest that benzodiazepines, propranolol, and anticholinergics may be of some help in treating acute akathisia. We recommend trials of propranolol, anticholinergics, or benzodiazepines for reducing the immediate distress that patients experience from restlessness.…”

Section: Management Of Akathisiamentioning

confidence: 99%

Chronic Restlessness With Antipsychotics

Bratti

Kane²,

Marder³

2007

AJP

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Treatment in Psychiatry begins with a hypothetical case illustrating a problem in current clinical practice. The authors review current data on prevalence, diagnosis, pathophysiology, and treatment. The article concludes with the authors' treatment recommendations for cases like the one presented.Mr. B is a 34-year-old man with a 13-year history of schizophrenia. His early treatment consisted of brief trials of first-generation antipsychotics, which he refused to take for any significant period of time. He was then started on risperidone at an average of 5 mg/day. Within a few months, he and his mother noticed that he had upper and lower extremity tremor and profound motor restlessness, especially of the legs. These symptoms worsened until Mr. B was taken off risperidone and started on olanzapine, after which the tremor resolved, but the restlessness persisted. Mr. B's discomfort was so severe that he was unable to sit through a 15-minute medication management appointment without getting up and pacing the room. His mother noted that the restlessness lasted throughout the day, relenting only when he slept. Mr. B stated that he could not stay still for more than a few minutes at a time and that he had an irresistible urge to move, which led him to pace the house and neighborhood until the soles of his feet were bleeding. Mr. B's mother also reported that when the restlessness was at its worst, he was extremely irritable, easily agitated, and sometimes violent.

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Section: Management Of Akathisiamentioning

confidence: 99%

Chronic Restlessness With Antipsychotics

Bratti

Kane²,

Marder³

2007

AJP

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“…To this aim, a systematic review analyzed the evidence of multiple known strategies and agents in management of akathisia. 132 Beta-blockers like propranolol and metoprolol have shown superiority over placebo in clinical trials, 133 134 and were considered the first option as an add-on medication. 132 Another drug with evidence to control akathisia is mirtazapine; a double-blind controlled study showed improvement in the treatment arm compared with controls, 134 and it was considered an option when β-blockers are not tolerated or ineffective.…”

Section: Akathisiamentioning

confidence: 99%

“Unvoluntary” Movement Disorders: Distinguishing between Tics, Akathisia, Restless Legs, and Stereotypies

2023

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Tics, stereotypies, akathisia, and restless legs fall at different places on the spectrum of discrete, unwanted and potentially disabling motor routines. Unlike tremor, chorea, myoclonus, or dystonia, this subgroup of abnormal movements is characterized by the subject's variable ability to inhibit or release undesired motor patterns on demand. Though it may be sometimes clinically challenging, it is crucial to distinguish these “unvoluntary” motor behaviors because secondary causes and management approaches differ substantially. To this end, physicians must consider the degree of repetitiveness of the movements, the existence of volitional control, and the association with sensory symptoms, or cognitive-ideational antecedent. This review aims to summarize the current existing knowledge on phenomenology, diagnosis, and treatment of tics, stereotypies, akathisia, and restless leg syndrome.

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Efficacy of Low-Dose Metoprolol in Neuroleptic-Induced Akathisia

Cited by 2 publications

References 0 publications

Chronic Restlessness With Antipsychotics

Chronic Restlessness With Antipsychotics

“Unvoluntary” Movement Disorders: Distinguishing between Tics, Akathisia, Restless Legs, and Stereotypies

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