Letters to the Editor/Volume 62, Number 7, July 2001
نویسندگان
چکیده
Sir: Akathisia may be defined as the subjective feeling of muscle discomfort usually manifesting as a result of treatment with antipsychotic medication. Moreover, the subjective experience is often associated with objective symptomatology such as restless leg movements, walking to and fro, and inability to sit in one place for an extended period of time. This undesirable side effect frequently expresses itself as a formidable therapeutic challenge. While akathisia is most commonly expressed following the use of antipsychotic medication, often it may be observed resulting from the use of antidepressant therapy, in particular drugs of the selective serotonin reuptake inhibitor (SSRI) class expressing serotonin-2A (5-HT2A) stimulatory effects. Various reports have estimated the occurrence rate of this phenomenon of SSRI-induced akathisia to range from 9.8% to 45.1%. The subjective discomfort experienced by the patient with akathisia is frequently disabling and of significant severity to the extent that it may even lead to suicidal behavior. Furthermore, akathisia often results in treatment noncompliance following the inability to tolerate the psychotropic medication. Nefazodone is an antidepressant with both presynaptic serotonin and norepinephrine reuptake properties as well as postsynaptic 5-HT2A blockade characteristics. 16 Considering its relatively unique receptor activity profile, we hypothesize that the medication will demonstrate beneficial effects in the reduction of akathisic symptomatology. To our knowledge, we present here the first reports of the utility of nefazodone in managing disabling akathisia following SSRI medication management. In these case reports, we demonstrate the marked and rapid improvement in akathisic symptomatology after a switch to treatment with nefazodone.
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