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Efficacy of nefazodone in the treatment of neuroleptic induced extrapyramidal side effects: a double‐blind randomised parallel group placebo‐controlled trial
Author(s) -
Wynchank Dora,
Berk Michael
Publication year - 2003
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.476
Subject(s) - akathisia , nefazodone , antipsychotic , placebo , psychology , tardive dyskinesia , haloperidol , dyskinesia , medicine , anesthesia , pharmacology , psychiatry , serotonin , fluoxetine , schizophrenia (object oriented programming) , dopamine , receptor , alternative medicine , disease , pathology , parkinson's disease
Abstract Many atypical antipsychotics show antagonism at both serotonergic and dopaminergic neurones and show fewer extrapyramidal side effects (EPS). Nefazodone blocks postsynaptic 5HT 2A receptors and weakly inhibits serotonin reuptake. This study aimed to elucidate the role of nefazodone in the treatment of antipsychotic‐induced EPS. The trial was a double‐blind, randomised, placebo‐controlled trial of patients requiring antipsychotic treatment with haloperidol 10 mg daily; from which a subgroup of patients who developed EPS were selected for the study. Patients were randomised to add‐on therapy with either placebo ( n = 24) or nefazodone ( n = 25) 100 mg bd. EPS were measured on days 0, 3 and 7 using the Simpson Angus, Barnes akathisia, abnormal involuntary movement and Chouinard scales. Nefazodone significantly reduced EPS as measured by both the Simpson Angus scale and CGI ( p = 0.007 and 0.0247, respectively). Akathisia and tardive dyskinesia did not differ between the two groups ( p = 0.601; p = 0.507, respectively). These results suggest the role of 5HT 2 antagonism in the mechanism of action of atypical antipsychotics with respect to lowering rates of drug‐induced EPS. In addition, a therapeutic role for nefazodone is suggested in the treatment of antipsychotic‐induced EPS. Copyright © 2003 John Wiley & Sons, Ltd.