Mirtazapine‐induced akathisia

Girishchandra, Boregowda; Johnson, Liana; Cresp, Rebecca M; Orr, Kenneth G.

doi:10.5694/j.1326-5377.2002.tb04387.x

Cited by 23 publications

(13 citation statements)

References 3 publications

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“…There is evidence to support the use of beta blockers, mirtazapine, benztropine, and benzodiazepines from small clinical trials of subjects with antipsychotic-induced akathisia,6,7,9 but no trials regarding the treatment of antidepressant-induced symptoms. The majority of existing publications regarding the treatment of mirtazapine-induced akathisia found the most efficacy with discontinuation of the mirtazapine2 or initiation of diazepam4 or other benzodiazepines 5. In this unique case, given the patient's history of substance use disorder, benzodiazepines were not considered.…”

Section: Discussionmentioning

confidence: 97%

“…While akathisia and psychomotor restlessness are listed as “warnings and precautions” occurring in less than 1% of the population prescribed mirtazapine,1 you can find more research citing mirtazapine as a treatment for antipsychotic-induced akathisia than case reports establishing it as the culprit 2-5. In fact, a head-to-head trial6 comparing the efficacy of mirtazapine to propranolol for antipsychotic-induced akathisia found mirtazapine to be as effective, if not better, and a well-tolerated treatment approach.…”

Section: Introductionmentioning

confidence: 99%

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Propranolol for mirtazapine-induced akathisia: Single case report

Koller

2019

Mental Health Clinician

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Propranolol for mirtazapine-induced akathisia: Single case report

Koller

2019

Mental Health Clinician

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“…For 1990 and 2019, a total of 52 reports containing 179 individuals that developed a MD associated with MTZ were identified from 20 different countries [ Table 1 ] [ 10 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 ]. 103 individuals were from European countries, 49 Asian, 17 Australian, 8 North American, and 2 South American.…”

Section: R Esultsmentioning

confidence: 99%

Mirtazapine-associated movement disorders: A literature review

Rissardo

Caprara

2020

Tzu Chi Med J

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Mirtazapine (MTZ) is an atypical antidepressant approved by the FDA, which mechanism of action involves the antagonism of alpha-2, H1, 5-HT2A, 5-HT2C, and 5-HT3 receptors. In this context, the aim of this literature review is to evaluate the clinical epidemiological profile, pathological mechanisms, and management of MTZ-associated movement disorders (MDs). Relevant reports of six databases were identified and assessed by two reviewers without language restriction. Fifty-two reports containing 179 cases from 20 countries were assessed. The mean age was 57 year (range, 17–85). The majority of the individuals were female (60%) and of European origin. The mean time from MTZ start to symptom onset was 7.54 days; the time from management to MD improvement was within one week in 82.60% of the individuals. The MDs associated with MTZ were 69 restless legs syndrome (RLS), 35 tremors, 10 akathisia (AKT), 9 periodic limb MD, 6 dystonia, 4 rapid eye movement sleep behavior disorders, 3 dyskinesia, 2 parkinsonism, and 1 tic, and in the group not clearly identified, 18 restlessness, 15 hyperkinesis, and 1 extrapyramidal symptom. In the literature, the majority of the reports lack important information about the neurological examination. The management should be the MTZ withdrawal, except in RLS that other options are possible. In AKT, the MTZ should not be rechallenge, and if available, the prescription of a benzodiazepine may reduce recovery time.

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“…Involvement of central serotonergic and adrenergic neurotransmitter systems has also been postulated 31. Risk factors for developing neuroleptic induced akathisia are not completely understood.…”

Section: Akathisiamentioning

confidence: 99%