Cyproheptadine versus propranolol for the treatment of acute neuroleptic-induced
akathisia: a comparative double-blind study.
Author(s): Fischel T(1), Hermesh H, Aizenberg D, Zemishlany Z, Munitz H, Benjamini Y,
Weizman A.
Affiliation(s): Author information:
(1)Geha Psychiatric Hospital and Felsenstein Medical Research Center, Rabin
Medical Center, Petah Tiqva, Israel.
Publication date & source: 2001, J Clin Psychopharmacol. , 21(6):612-5
The purpose of this study was to investigate the efficacy of cyproheptadine, an
antiserotonergic agent, in the treatment of neuroleptic-induced akathisia (NIA),
as compared with propranolol, the current gold standard. In a double-blind trial,
30 patients with schizophrenia and NIA received either cyproheptadine 16 mg/day
(N = 18) or propranolol 80 mg/day (N = 12) for 4 days, followed by 3 days without
any anti-NIA treatment. The Barnes Akahisia Scale, Simpson-Angus Extrapyramidal
Effects Rating Scale, and Brief Psychiatric Rating Scale were used to assess the
severity of NIA, parkinsonism, and psychosis, respectively. In both groups, the
severity of NIA decreased significantly over time (cyproheptadine, -46%;
propranolol, -42%), with no significant intergroup difference. The NIA symptoms
worsened significantly when cyproheptadine and propranolol were discontinued. We
conclude that cyproheptadine 16 mg/day is as effective as propranolol for the
treatment of acute NIA. The antiakathisic effect of cyproheptadine may be mostly
attributable to its serotonin antagonistic activity.
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