Chidiac Madeline, Elhusein Bushra, Gajebasia Niman
Department of Psychiatry, London Health Sciences Centre, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
SAGE Open Med Case Rep. 2024 Nov 28;12:2050313X241299947. doi: 10.1177/2050313X241299947. eCollection 2024.
Antipsychotic-induced akathisia is a distressing movement disorder marked by intense internal restlessness and an urge to move. This report discusses a 44-year-old man with a diagnosis of schizophrenia who developed severe, treatment-resistant akathisia after taking haloperidol, a first-generation antipsychotic. Standard treatments for antipsychotic-induced akathisia, including benzodiazepines (Clonazepam) and benztropine, failed to alleviate the patient's persistent symptoms, causing considerable distress. However, the introduction of mirtazapine at a low dose of 15 mg led to substantial improvement, as indicated by a gradual reduction in the Barnes Akathisia Rating Scale score from 8 to 0 and improvements in mood, mobility, and daily activity participation. This case highlights the potential efficacy of mirtazapine in treating severe, resistant akathisia, adding to its established use in antipsychotic-induced akathisia management and contributing to the limited literature on its application in patients unresponsive to other conventional treatments.
抗精神病药物所致静坐不能是一种令人痛苦的运动障碍，其特征为强烈的内心不安和运动冲动。本报告讨论了一名44岁被诊断为精神分裂症的男性，他在服用第一代抗精神病药物氟哌啶醇后出现了严重的、难治性静坐不能。抗精神病药物所致静坐不能的标准治疗方法，包括苯二氮䓬类药物（氯硝西泮）和苯海索，均未能缓解该患者的持续症状，给他带来了相当大的痛苦。然而，低剂量15毫克米氮平的引入带来了显著改善，巴恩斯静坐不能评定量表评分从8分逐渐降至0分，同时情绪、活动能力和日常活动参与度也有所改善。该病例突出了米氮平在治疗严重难治性静坐不能方面的潜在疗效，这进一步证明了其在抗精神病药物所致静坐不能管理中的既定用途，也为其在对其他传统治疗无反应的患者中的应用这一有限文献增添了内容。
