Neuroleptic induced akathisia is a common and distressful extrapyramidal side effect of antipsychotic treatment. A significant proportion of the variability of its development has been left unexplained and has to be attributed to individual susceptibility. Since hereditary factors have been discussed in the etiology of acute akathisia (AA), part of the individual susceptibility might be of genetic origin. Moreover, AA is regarded as a forerunner of tardive dyskinesia, a drug-induced chronic movement disorder, which may be associated with homozygosity for the Ser9Gly variant of the DRD3 gene. Considering expression studies, which demonstrated functional variants of DRD3 polymorphisms, we investigated whether homozygosity for the Ser9Gly variant of the DRD3 gene is associated with AA. Homozygosity for the Ser9Gly variant of the DRD3 gene was connected to an 88% incidence of AA as compared with a considerably lower 46.9% incidence of AA in schizophrenic patients nonhomozygous for the 2-2 allele (exact P = 0.0223). Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:187-191, 2000.
Homozygosity for the long variant of the 5-HTTLPR may cause a predisposition to increased night-time motor activity in conjunction with SSRI treatment.
Objectlves: To verify the efficacy of fluvoxamine versus lithium in reducing aggressive behavior in people with personality disorders.Methods: Study partecipants were 50 physically health men (26) and women (24) randomly chosen within the inhabitants of Florence who were known to have aggressive behavior for a period longer than 1 years (total score'on the Social Disfunction Aggressivity Scale (SDAS) greater than 14) and met DSM-IV criteria for personality disorders by administration of the SCID-II. They did not present axis I disorders, history of head trauma, previous ECT treatment, depressive symptoms (score lower than I8 at the Hamilton RS-D, lower than I4 at the Beck DI). The trial was a double-blind fixed-dose design comparing fluvoxamine (300 mg/day) and lithium (900 mg/day). During the first of Cweek single-blind placebo, before starting treatment, and after 30, 60, 90, 120, and 150 days of therapy, all patients had a global clinic assessment, and a specific one for aggressivity.
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