Propranolol in the treatment of neuroleptic-induced akathisia (NIA) in schizophrenics: A double-blind, placebo-controlled study

Kramer, Mark S.; Gorkin, Robert A.; DiJohnson, Celeste; Sheves, Patricia

doi:10.1016/0006-3223(88)90260-0

Cited by 36 publications

(27 citation statements)

References 12 publications

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“…The e¦cacy of b-blockers on akathisia has been conÞrmed with propranolol (Lipinski et al 1983Adler et al 1986Adler et al , 1987Kramer et al 1988), pindolol (Kato et al 1976;Reiter et al 1987a), metoprolol , and betaxolol (Dupuis et al 1987), but not with atenolol (Reiter et al 1987b) and sotalol (Ratey et al 1985). Drugs with higher intracerebral penetration tend to show a more marked e¤ect.…”

Section: Discussionmentioning

confidence: 96%

Intracerebral penetration of carteolol hydrochloride in rats

et al. 1997

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To elucidate the penetrability of carteolol, a beta-adrenoceptor antagonist (beta-blocker) into the brain of rats, intracerebral and serum concentrations of the compound were determined in male rats receiving single or repetitive oral administration of carteolol hydrochloride at 30 mg/kg. The time-course of the intracerebral concentration of carteolol following single IV administration of the compound at 10 and 30 mg/kg was also studied in male rats. A high-performance liquid chromatography method was used to determine the intracerebral and serum concentrations. Following single oral dosing, the intracerebral concentration of carteolol reached a maximum of 0.074 microgram/g at 2 h postdosing and declined with a half-life of 3.7 h, and the Cmax and AUC of carteolol in the brain were 12.5% and 19.8% of those in serum. The intracerebral and serum concentrations of carteolol were determined in male rats receiving repetitive oral dosing of the compound once daily for 7 days. The concentration of carteolol in the brain and serum at 1 h postdosing varied within a range of 0.059-0.091 microgram/g and 0.321-0.443 microgram/ml, respectively, throughout the dosing period, showing no changes in the penetrability of the compound into the brain due to repeated dosing. The concentration of carteolol in the brain and serum increased in a dose-dependent manner in rats receiving a single IV administration of the compound. The elimination half-life of carteolol in the serum and brain was 0.6-0.8 h and 1.3-1.7 h, respectively, in rats following single IV dosing of the compound. The half-life in the brain was about twice as long as that in the serum. The brain to serum concentration ratio was 0.306:0.499. From the above results, it was concluded that carteolol is distributed from the circulation to the brain with low penetrability.

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Section: Discussionmentioning

confidence: 96%

Intracerebral penetration of carteolol hydrochloride in rats

et al. 1997

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“…In a series of studies, β‐blockers (e.g. propranolol) have been shown to be effective in treating akathisia ( Kramer et al 1988 , Yassa et al 1988 , Flischhacker 1991). These trials have led to speculation that akathisia may be mediated by pathways that are extrastriatal, perhaps involving the mesocortical dopamine system possibly through the antagonism of noradrenaline β‐adrenergic receptors.…”

Section: Treatment Of Acute Epsmentioning

confidence: 99%

What can we do about acute extrapyramidal symptoms?

Gray¹,

Gournay²

2000

Psychiatric Ment Health Nurs

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Antipsychotic drugs are the most effective treatment for psychotic disorders such as schizophrenia. However, they are known to cause a range of side-effects including acute extrapyramidal symptoms (EPS) that are both distressing and disabling. Mental health nurses play a critical role in both the detection and the management of these symptoms. A review of the literature was conducted to identify strategies for managing acute EPS. Despite a widely held belief that EPS are associated with noncompliance with medication, the data to support this hypothesis are weak. Although akathisia may negatively affect the treatment outcome, there was little evidence to suggest that parkinsonism or dystonia do. Whilst the use of anticholinergic medication may be helpful in treating acute parkinsonism and dystonia they were associated with their own side-effects and the benefit of long-term prophylactic treatment is doubtful. The literature suggests that logical prescribing and rapid detection and management of acute EPS will result in a substantial reduction in the incidence of these disabling side-effects.

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“…In addition, ␤-blockers are used to prevent symptoms of hyperthyroidism and some forms of tremor. The side effect of ␤-blocker drugs is congestive heart failure, bradycardia, fatique and brochospasms [1][2][3]. Several analytical methods based on, spectrophotometry, phosphorescence, gas chromatography, high performance liquid chromatography (HPLC), electrospray ionization-mass spectrometry (ESI-MS) and HPLC-MS have been described in the literatures for the determination of the ␤-blocker drugs from various samples [4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%