Poyurovsky Michael, Weizman Abraham
J Clin Psychopharmacol. 2018 Dec;38(6):609-611. doi: 10.1097/JCP.0000000000000972.
Some evidence suggests that off-label use of mirtazapine (15 mg) is effective in treatment of acute antipsychotic-associated akathisia (AAA). We analyzed whether a lower dose of mirtazapine (7.5 mg) maintained its antiakathisia properties while exhibiting better tolerability in patients with schizophrenia and mood disorders who developed acute AAA.
Medical charts were retrospectively evaluated for 12 patients with AAA. All scored at least 2 (mild akathisia) on the Barnes Akathisia Rating Scale (BARS) and were treated with mirtazapine (7.5 mg) for a mean of 10.3 days.
There was a statistically significant decrease in the BARS subjective, distress, and global (P < 0.01 to P < 0.001), but not objective (P = 0.63), subscales. Five participants (41.6%) fulfilled the predefined criterion of response, a decrease of at least 2 points on the BARS global subscale. The positive antiakathisia effect of mirtazapine was observed predominantly in aripiprazole-treated patients. Mirtazapine (7.5 mg) was well tolerated, and no clinically significant adverse effects, primarily drowsiness or increased appetite, were reported.
A large-scale controlled evaluation is warranted to substantiate clinical utility of off-label use of mirtazapine (7.5 mg) for patients with AAA.
一些证据表明，米氮平（15毫克）的非标签使用对治疗急性抗精神病药物所致静坐不能（AAA）有效。我们分析了较低剂量的米氮平（7.5毫克）在患有急性AAA的精神分裂症和心境障碍患者中是否能保持其抗静坐不能特性，同时表现出更好的耐受性。
对12例AAA患者的病历进行回顾性评估。所有患者在巴恩斯静坐不能评定量表（BARS）上的得分至少为2分（轻度静坐不能），并接受米氮平（7.5毫克）治疗，平均治疗10.3天。
BARS主观、痛苦和总体量表得分有统计学显著下降（P<0.01至P<0.001），但客观量表得分无下降（P=0.63）。5名参与者（41.6%）达到了预先定义的反应标准，即BARS总体量表得分至少下降2分。米氮平的抗静坐不能积极作用主要在接受阿立哌唑治疗的患者中观察到。米氮平（7.5毫克）耐受性良好，未报告主要为嗜睡或食欲增加等具有临床意义的不良反应。
有必要进行大规模对照评估，以证实米氮平（7.5毫克）非标签使用对AAA患者的临床效用。
