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Efficacy of nefazodone in the treatment of neuroleptic induced extrapyramidal side effects: a double-blind randomised parallel group placebo-controlled trial

✍ Scribed by Dora Wynchank; Michael Berk

Publisher
John Wiley and Sons
Year
2003
Tongue
English
Weight
56 KB
Volume
18
Category
Article
ISSN
0885-6222

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✦ Synopsis

Abstract

Many atypical antipsychotics show antagonism at both serotonergic and dopaminergic neurones and show fewer extrapyramidal side effects (EPS). Nefazodone blocks postsynaptic 5HT~2A~ receptors and weakly inhibits serotonin reuptake. This study aimed to elucidate the role of nefazodone in the treatment of antipsychotic‐induced EPS. The trial was a double‐blind, randomised, placebo‐controlled trial of patients requiring antipsychotic treatment with haloperidol 10 mg daily; from which a subgroup of patients who developed EPS were selected for the study. Patients were randomised to add‐on therapy with either placebo (n = 24) or nefazodone (n = 25) 100 mg bd. EPS were measured on days 0, 3 and 7 using the Simpson Angus, Barnes akathisia, abnormal involuntary movement and Chouinard scales. Nefazodone significantly reduced EPS as measured by both the Simpson Angus scale and CGI (p = 0.007 and 0.0247, respectively). Akathisia and tardive dyskinesia did not differ between the two groups (p = 0.601; p = 0.507, respectively). These results suggest the role of 5HT~2~ antagonism in the mechanism of action of atypical antipsychotics with respect to lowering rates of drug‐induced EPS. In addition, a therapeutic role for nefazodone is suggested in the treatment of antipsychotic‐induced EPS. Copyright © 2003 John Wiley & Sons, Ltd.

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