Abstract
References
- 1 Sun Pharmaceutical Industries, Inc. Mirtazapine tablet. In: DailyMed [Internet]. Bethesda (MD): National Library of Medicine (US2005 (rev. 2017 Dec; cited 2018 Jun). Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid1⁄4f23631be- c7ae-46e9-b771-a70be17bc9f0
- 2. Adler LA, Angrist B, Reiter S, Rotrosen J. Neuroleptic-induced akathisia: a review. Psychopharmacology (Berl). 1989;97(1):1-11. doi: 10.1007/BF00443404. PMID: 2565586.
- 3. De Boer T. The effects of mirtazapine on central noradrenergic and serotonergic neurotransmission. Int Clin Psychopharmacol 1995; 10(Spull.4):19-23.
- 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;59:1071–7.
- 5. Gulsun M, Doruk A. Mirtazapine-induced akathisia. J Clin Psychopharmacol. 2008;28:467.
- 6. Brosda J, Jantschak F, Pertz HH. alpha2-Adrenoceptors are targets for antipsychotic drugs. Psychopharmacology (Berl) 2014;231:801–12.
- 7. Koliscak LP, Makela EH. Selective serotonin reuptake inhibitor-induced akathisia. J Am Pharm Assoc (2003). 2009;49(2):e28-36; quiz e37-8. doi: 10.1331/JAPhA.2009.08083.
- 8. Pratap A, Akhtar S, Sinha P, Bakhla A.K. Escitalopram-induced severe akathisia leading to suicide attempt. Industrial psychiatry journal, 2019;28(2):315–317. 9. Revet A, Montastruc F., Roussin A, Raynaud J. P, Lapeyre-Mestre M, Nguyen T. Antidepressants and movement disorders: a postmarketing study in the world pharmacovigilance database. BMC psychiatry, 2020; 20(1), 308.
- 10.Praharaj S.K., Kongasseri S, Behere R.V, Sharma P.S.V.N. Mirtazapine for antipsychotic-induced acute akathisia: a systematic review and meta-analysis of randomized placebo-controlled trials. Therapeutic advances in psychopharmacology, 2015; 5(5), 307-313.
- 11. Akagi H, Kumar TM. Lesson of the week: akathisia: overlooked at a cost. BMJ. 2002;324:1506–7.
- 12. Markoula S, Konitsiotis S, Chatzistefanidis D, Lagos G, Kyritsis AP. Akathisia induced by mirtazapine after 20 years of continuous treatment. Clin Neuropharmacol. 2010;33(1):50-1.
- 13. Raveendranathan, D., &Swaminath, G. R. (2015). Mirtazapine Induced Akathisia: Understanding a Complex Mechanism. Indian journal of psychological medicine, 37(4), 474–475. https://doi.org/10.4103/0253-7176.168615
- 14. Koller K. Propranolol for mirtazapine-induced akathisia: Single case report. The mental health clinician, 2019;9(1):61–63. https://doi.org/10.9740/mhc.2019.01.061.
- 15. Sieminski M, Zemojtel L. Akathisia Is More Than Restlessness in the Legs. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 2019; 15(9), 1383. https://doi.org/10.5664/jcsm.7944.
- 16. Lipinski, JF, Mallya G, Zimmerman P, Pope HG. Fluoxetine-in- duced akathisia: clinical and theoretical implications. J Clin Psy- chiatry. 1989;50:339–42.
- 17. Settle EC. Akathisia and sertraline. J Clin Psychiatry. 1993;54:321.
- 18.Opler LA. Sertralineandakathisia. Am J Psychiatry.1994;151:620– 1.
- 19. Hansen L. A critical review of akathisia, and its possible association with suicidal behaviour. Hum Psychopharmacol. 2001;16(7):495-505. doi: 10.1002/hup.325.
Abstract
Akathisia is a movement disorder characterized by an inner sense of restlessness and it needs attention because of the increased risk of suicidal behavior. Although akathisia may affect the trunk and arms, it predominantly affects the legs. Akathisia may occur exposure to antipsychotics and antidepressants. Mirtazapine is an antidepressant blocking presynapticα-2adrenergic receptors and 5-hydroxytryptamine (5-HT) 2A/2C, 5 HT 3 and histaminergic postsynaptic receptor. In this single case study, we aimed to present a case of akathisia which occurred after mirtazapine treatment.
Case presentation: A fifty -two-years-old woman presented with a-one-month history of decreased sleep and appetite. She had been using antidepressant medication (Fluoxetine 40 mg / day) for five months due to depressive disorder. Mirtazapine 15 mg/day was added to the patient's treatment. Three hours after the first dosage she could not sit even for few minutes and complained of inner restlessness. She reported feeling anxious. Biochemical tests for metabolic/electrolyte parameters were within reference ranges. She had no neurological disease. Mirtazapine was removed and her symptoms resolved in one day.
She consulted the department of internal medicine. Her physical examination was normal. Biochemical tests for metabolic/electrolyte parameters were within reference ranges. She had no neurological disease. Mirtazapine was removed and her symptoms resolved in one day.
Akathisia is an important side effect because of related to a subjective experience of discomfort that can lead to suicidal behavior. This case illustrates the significant of being alert to any movement disorders in patients treated with mirtazapine.
Keywords
References
- 1 Sun Pharmaceutical Industries, Inc. Mirtazapine tablet. In: DailyMed [Internet]. Bethesda (MD): National Library of Medicine (US2005 (rev. 2017 Dec; cited 2018 Jun). Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid1⁄4f23631be- c7ae-46e9-b771-a70be17bc9f0
- 2. Adler LA, Angrist B, Reiter S, Rotrosen J. Neuroleptic-induced akathisia: a review. Psychopharmacology (Berl). 1989;97(1):1-11. doi: 10.1007/BF00443404. PMID: 2565586.
- 3. De Boer T. The effects of mirtazapine on central noradrenergic and serotonergic neurotransmission. Int Clin Psychopharmacol 1995; 10(Spull.4):19-23.
- 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;59:1071–7.
- 5. Gulsun M, Doruk A. Mirtazapine-induced akathisia. J Clin Psychopharmacol. 2008;28:467.
- 6. Brosda J, Jantschak F, Pertz HH. alpha2-Adrenoceptors are targets for antipsychotic drugs. Psychopharmacology (Berl) 2014;231:801–12.
- 7. Koliscak LP, Makela EH. Selective serotonin reuptake inhibitor-induced akathisia. J Am Pharm Assoc (2003). 2009;49(2):e28-36; quiz e37-8. doi: 10.1331/JAPhA.2009.08083.
- 8. Pratap A, Akhtar S, Sinha P, Bakhla A.K. Escitalopram-induced severe akathisia leading to suicide attempt. Industrial psychiatry journal, 2019;28(2):315–317. 9. Revet A, Montastruc F., Roussin A, Raynaud J. P, Lapeyre-Mestre M, Nguyen T. Antidepressants and movement disorders: a postmarketing study in the world pharmacovigilance database. BMC psychiatry, 2020; 20(1), 308.
- 10.Praharaj S.K., Kongasseri S, Behere R.V, Sharma P.S.V.N. Mirtazapine for antipsychotic-induced acute akathisia: a systematic review and meta-analysis of randomized placebo-controlled trials. Therapeutic advances in psychopharmacology, 2015; 5(5), 307-313.
- 11. Akagi H, Kumar TM. Lesson of the week: akathisia: overlooked at a cost. BMJ. 2002;324:1506–7.
- 12. Markoula S, Konitsiotis S, Chatzistefanidis D, Lagos G, Kyritsis AP. Akathisia induced by mirtazapine after 20 years of continuous treatment. Clin Neuropharmacol. 2010;33(1):50-1.
- 13. Raveendranathan, D., &Swaminath, G. R. (2015). Mirtazapine Induced Akathisia: Understanding a Complex Mechanism. Indian journal of psychological medicine, 37(4), 474–475. https://doi.org/10.4103/0253-7176.168615
- 14. Koller K. Propranolol for mirtazapine-induced akathisia: Single case report. The mental health clinician, 2019;9(1):61–63. https://doi.org/10.9740/mhc.2019.01.061.
- 15. Sieminski M, Zemojtel L. Akathisia Is More Than Restlessness in the Legs. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 2019; 15(9), 1383. https://doi.org/10.5664/jcsm.7944.
- 16. Lipinski, JF, Mallya G, Zimmerman P, Pope HG. Fluoxetine-in- duced akathisia: clinical and theoretical implications. J Clin Psy- chiatry. 1989;50:339–42.
- 17. Settle EC. Akathisia and sertraline. J Clin Psychiatry. 1993;54:321.
- 18.Opler LA. Sertralineandakathisia. Am J Psychiatry.1994;151:620– 1.
- 19. Hansen L. A critical review of akathisia, and its possible association with suicidal behaviour. Hum Psychopharmacol. 2001;16(7):495-505. doi: 10.1002/hup.325.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case reports |
| Authors | |
| Publication Date | December 31, 2021 |
| Published in Issue | Year 2021 Volume: 7 Issue: 3 |
e-ISSN 2149-7796