Poyurovsky M, Shardorodsky M, Fuchs C, Schneidman M, Weizman A
Research Unit, Tirat Carmel Mental Health Center, Israel.
Br J Psychiatry. 1999 Mar;174:238-42. doi: 10.1192/bjp.174.3.238.
Serotonin (5-HT):dopamine imbalance may underlie neuroleptic-induced akathisia.
To evaluate the efficacy of the 5-HT2 antagonist, mianserin in neuroleptic-induced akathisia.
Thirty neuroleptic-treated patients with schizophrenia were randomly allocated in a double-blind design to receive either mianserin (15 mg/day) or placebo for five days. Patients were assessed at baseline and on Days 3 and 5 by the Barnes Akathisia Scale (BARS), as well as by other relevant clinical rating scales.
Compared with the placebo group, the mianserin-treated patients showed a significant reduction in all four BARS subscales by Day 5, with mean reductions in the BARS global score of 9.9% and 52.2%, respectively (P = 0.006). Response to treatment (a reduction of at least two points on the BARS global subscale), was noted in six patients (40%) in the mianserin group and only one patient (9.1%) in the placebo group (P = 0.04, log odds ratio 2.23).
Mianserin at a low dose may be a promising therapeutic option for patients with acute neuroleptic-induced akathisia.
血清素（5-羟色胺，5-HT）与多巴胺失衡可能是抗精神病药物所致静坐不能的潜在原因。
评估5-HT2拮抗剂米安色林治疗抗精神病药物所致静坐不能的疗效。
30例接受抗精神病药物治疗的精神分裂症患者按双盲设计随机分组，分别接受米安色林（15毫克/天）或安慰剂治疗5天。在基线时以及第3天和第5天，采用巴恩斯静坐不能量表（BARS）以及其他相关临床评定量表对患者进行评估。
与安慰剂组相比，米安色林治疗组患者在第5天时，BARS量表所有4个分量表的得分均显著降低，BARS量表总分平均降幅分别为9.9%和52.2%（P = 0.006）。米安色林组有6例患者（40%）对治疗有反应（BARS量表总分分量表至少降低2分），而安慰剂组仅有1例患者（9.1%）有反应（P = 0.04，对数优势比2.23）。
低剂量米安色林可能是急性抗精神病药物所致静坐不能患者的一种有前景的治疗选择。
