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      Farmacoterapia de la acatisia aguda inducida por neurolépticos Translated title: Pharmacological treatment of neuroleptic-induced akathisia

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          Abstract

          La acatisia aguda es un trastorno del movimiento bastante molesto, caracterizado por sensación subjetiva y signos objetivos de inquietud motora, que se presenta frecuentemente como efecto adverso de los neurolépticos; un tratamiento oportuno es necesario para garantizar una buena adherencia al manejo con antipsicóticos y prevenir recaídas. Se describe el estado actual de los tratamientos disponibles para la acatisia aguda inducida por neurolépticos, valorando efectividad y tolerabilidad. Se realizó una búsqueda electrónica en Pubmed, Science Alert, Springer link, SciELO, Ovid y Elsevier con criterios de selección específicos, obteniendo 87 estudios, de los cuales se escogieron 51 teniendo en cuenta relevancia clínica, nivel de evidencia y actualidad. En este artículo se describen los resultados de la búsqueda. Las benzodiacepinas, los betabloqueadores lipofílicos de acción central y los anticolinérgicos son los fármacos más estudiados para el tratamiento de este trastorno del movimiento; los dos primeros han mostrado superioridad, sin embargo, se necesita aún bastante investigación al respecto.

          Translated abstract

          Acute Akathisia is a movement disorder rather annoying; characterized by subjective feelings and objective signs of restlessness, which often presents as a side effect of neuroleptics, early treatment is necessary to ensure good adherence to treatment with antipsychotics and prevent relapses. To describe the state of the art of available treatments for neuroleptic-induced acute akathisia, taking into account effectiveness and tolerability. An electronic search in Pubmed, Science Alert, Springer link, SciELO, Ovid and Elsevier with specific eligibility criteria, obtaining 87 studies, of which were chosen 51 of them manually, according to their clinical relevance, topicality and level of evidence. In this paper, we describe the results of the search. The benzodiazepines, centrally acting lipophilic beta-blockers and anticholinergics, are the most studied drugs to treat this movement disorder, the first two have shown superiority; however, considerable research is still needed in this regard.

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          Acute antipsychotic-induced akathisia revisited.

          Akathisia remains one of the most prevalent and distressful antipsychotic-induced adverse events. Effective and well-tolerated treatment is a major unmet need in akathisia that merits a search for new remedies. Accumulating evidence indicates that agents with marked serotonin-2A receptor antagonism may represent a new class of potential anti-akathisia treatment.
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            Serotonin-based pharmacotherapy for acute neuroleptic-induced akathisia: a new approach to an old problem.

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              Treatment of neuroleptic-induced akathisia with the 5-HT2A antagonist trazodone.

              Akathisia is a common and distressful extrapyramidal adverse side effect usually resulting from the use of antipsychotic medications. Early management of akathisia is important because it may be associated with poor treatment response and medication noncompliance. Unfortunately many patients fail to respond to standard management of akathisia. In addition to dopaminergic mechanisms, it has been hypothesized that serotonin may play a prominent role in the pathophysiology of akathisia. Trazodone is an antidepressant agent demonstrating prominent serotonergic antagonistic properties. This open-label pilot study investigates the efficacy of trazodone in the management of akathisia. Nine female patients with a score of at least "mild akathisia" on the Barnes Akathisia Scale, and receiving a stable dose of antipsychotic medication, were administered trazodone, titrated up to a dosage of 100 mg/day over a period of 5 days. The patients demonstrated marked improvement in symptoms of akathisia. In addition, some improvement was noted in symptomatology of anxiety, depression, and psychosis. These observations suggest the use of trazodone as a beneficial and relatively safe medication for the treatment of antipsychotic medication-induced akathisia. Further study in the context of a double-blind, placebo-controlled trial is mandated to substantiate these preliminary findings.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                anco
                Acta Neurológica Colombiana
                Acta Neurol Colomb.
                Asociación Colombiana de Neurología
                0120-8748
                October 2015
                : 31
                : 4
                : 447-453
                Affiliations
                [1 ] Universidad Nacional de Colombia Colombia
                [2 ] Fundación Sueño Vigilia Colombiana Colombia
                [3 ] Universidad Nacional de Colombia Colombia
                Article
                S0120-87482015000400014
                fa6b0a2c-090a-44d4-942c-90e3c6dcf5bf

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                SciELO Colombia

                Self URI (journal page): http://www.scielo.org.co/scielo.php?script=sci_serial&pid=0120-8748&lng=en
                Categories
                MEDICINE, GENERAL & INTERNAL

                Internal medicine
                Acatisia inducida por medicamentos,agitación psicomotora,antipsicóticos,efectos adversos,trastornos del movimiento,inducidos químicamente,Akathisia,drug-induced,antipsychotic agents,adverse effects,movement disorders,chemically induced,psychomotor agitation

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