Posted by fenix on November 27, 2007, at 16:22:42
In reply to Re: List Of Possible Treatments For Tardive Akathi, posted by pstrait on November 27, 2007, at 16:02:35
> Then why include selegiline or ritanserin? Ritanserin works for the same reason mianserin and mirtazapine work -- they are 5ht2 antagonists.
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> I'm not sure why you wouldn't want to consider these medicines.
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> Medlink's article on Tardive Akathisia includes the following:
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> Management
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> It is important that psychotic patients be warned about the possible development of akathisia from taking neuroleptics, lest they misinterpret the condition as worsening agitation and stop taking their medication or become suicidal (Drake and Ehrlich 1985). The surest remedy for acute or subacute akathisia is to reduce or eliminate intake of the offending drug. If this is not feasible, consider substituting one of the newer antipsychotics with a lower propensity to causing akathisia. No universally successful treatment exists, but antipsychotic-induced akathisia may respond to a variety of medications. The most consistently effective appear to be beta-blockers (Miller and Fleischhacker 2000). Nonselective serotonin antagonists such as mirtazapine, ritanserin, mianserin, and cyproheptadine may also be beneficial (Fischel et al 2001; Poyurovsky et al 2003). Other agents reported to relieve symptoms of akathisia include anticholinergics, amantadine, clonidine, benzodiazepines (Lima et al 2002), opiates, nicotine patches, and trazodone (Stryjer et al 2003). Acute, severe akathisia may respond to intravenous or intramuscular biperiden (Hirose and Ashby 2000) or intravenous diazepam (Hirose and Ashby 2002).
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> In tardive akathisia, the catecholamine depletors reserpine and tetrabenazine have been the most effective agents (Burke et al 1989), much as in tardive dyskinesia.
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>Side-effects pretty much, and the fact that ADs and the like give me shivers when I think about them.
Your argument could then be that the side-effects are similar. Well, then my argument would be that I decided not to try and include ADs and APs in the list because a) I was interested in things that could treat TA that are not ADs and APs and b) because even though ADs and APs could treat TA they could worsen it in the long run (especially APs I think). Then your argument could be that so could the other things I mentioned worsen it perhaps in the long run.
So then I will just say that I was interested in treatments that are not ADs or APs. Why is that? I was researching more in the realm of Dyskinisia and Parkinsons, drugs you might give for those or neuropathic pains. Some of the things I mentioned I don't think you would see being given for TA, I was thinking that these drugs might work though.
poster:fenix
thread:797290
URL: http://www.dr-bob.org/babble/20071125/msgs/797330.html