Paliperidon palmitat enjeksiyonu sonrasi gelişen akatizinin mirtazapinle başarili tedavisi: Bir olgu sunumu

Abstract

Paliperidon palmitat uzun etkili enjekte edilebilir bir preparattır ve şizofreninin akut ve idame tedavisinde endikedir. Akatizi, iç huzursuzluk ve hareket etmeye devam etme gereksinimi ile karakterize ekstrapiramidal bir semptomdur. Antipsikotikle indüklenen akatizi tedavisinde β-blokerler, benzodiazepinler ve antikolinerjikler kullanılmasına rağmen, mirtazapinin de etkili olduğu gösterilmiştir. Ancak, literatür taramamızda, uzun etkili antipsikotiklerin kullanımıyla ilişkili akatizi tedavisinde mirtazapin kullanımıyla ilgili bir olguya rastlanmamıştır. Bu olgu rutin akatizi tedavisiyle fayda görmeyip, sadece mirtazapinden yarar görmüştür.

Keywords

• Antipsikotik,Şizofreni,Paliperidon palmitat,Akatizi,Mirtazapin

Successful treatment of paliperidone palmitate induced akathisia with mirtazapine: A case report

Abstract

Paliperidone palmitate is a long-acting injectable preparation and is indicated in acute and maintenance treatment of schizophrenia. Akathisia is an extrapyramidal symptom characterized by inner restlessness and the need to keep moving. Although β-blockers, benzodiazepines and anticholinergics have been used in the treatment of antipsychotic-induced akathisia, mirtazapine is also effective in the treatment of antipsychotic-induced akathisia. However, our search of literature did not reveal any cases of use mirtazapine in the treatment of akathisia associated with the use of long-acting antipsychotics. In this case, we used each treatment line to be used in the treatment of akathisia; however, the patient could be stabilized only by mirtazapine.

Keywords

• Schizophrenia,Paliperidone palmitate,Akathisia,Mirtazapine,Antipsychotic

References

1. References:1. Kramer M, Litman R, Hough D, Lane R, Lim P, Liu Y, Eerdekens M. Paliperidone palmitate, a potential long-acting treatment for patients with schizophrenia. Results of a randomized, double-blind, placebo-controlled efficacy and safety study. Intl J Neuropsychopharm 2010; 13: 635–47.
2. 2. Taylor D. Psychopharmacology and adverse effects of antipsychotic long-acting injections: a review. Br JPsychiatry Suppl. 2009; 52: 13–9.
3. 3. Hieber R, Dellenbaugh T, Nelson LA. Role of mirtazapine in the treatment of antipsychotic-induced akathisia. Ann. Pharmacother 2008; 42: 841–46.
4. 4. Poyurovsky M, Pashinian A, Weizman R, Fuchs C, Weizman A. Low-dose mirtazapine: A new option in the treatment of antipsychotic-induced akathisia. A randomized, double-blind, placebo- and propranolol-controlled trial. Biol Psychiatry 2006; 59:1071-77.
5. 5. Poyurovsky M, Epshtein S, Fuchs C, Schneidman M, Weizman R, Weizman A. Efficacy of low-dose mirtazapine in neuroleptic-induced akathisia: a double-blind randomized placebo-controlled pilot study. J Clin Psychopharmacol 2003; 23: 305–8.
6. 6. Barnes TR. A rating scale for drug-induced akathisia. Br J Psychiatry 1989; 154: 672–6.
7. 7. Shayegan DK, Stahl SM. Atypical antipsychotics: matching receptor profile to individual patient’s clinical profile. CNS Spectr 2004; 9: 6–14.
8. 8. Gulsun M, Doruk A. Mirtazapine-induced akathisia. J Clin Psychopharmacol 2008; 28 :467.

9. 9. Ozyildirim I, Kosecioglu S. Mirtazapine induced tardive akathisia: a case report. Eur Psychiatry 2009; 24: 507.
10. 10. Raveendranathan D, Swaminath GR. Mirtazapine Induced Akathisia: Understanding a Complex Mechanism. Indian J Psychol Med 2015; 37: 474.