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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.
journal contributionposted on 2003-06-01, 00:00 authored by D Wynchank, Michael BerkMichael Berk
Many atypical antipsychotics show antagonism at both serotonergic and dopaminergic neurones and show fewer extrapyramidal side effects (EPS). Nefazodone blocks postsynaptic 5HT2A 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 10mg 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) 100mg 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 5HT2 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.
Pagination271 - 275
Publication classificationC1.1 Refereed article in a scholarly journal
Copyright notice2003, Wiley
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Acute DiseaseAntidepressive Agents, Second-GenerationAntipsychotic AgentsBasal Ganglia DiseasesChronic DiseaseDouble-Blind MethodFemaleHaloperidolHumansMaleReceptors, Serotonin, 5-HT2SchizophreniaSerotonin AntagonistsSubstance-Related DisordersTriazolesScience & TechnologySocial SciencesLife Sciences & BiomedicineClinical NeurologyPharmacology & PharmacyPsychiatryPsychologyNeurosciences & Neurologynefazodoneextrapyramidal side effectsparkinsonismakathisia5-HT2 ANTAGONIST RITANSERININDUCED AKATHISIAMIRTAZAPINEANTIDEPRESSANTPHARMACOLOGYSYMPTOMSDRUG