This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Web of Science (2) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Back, I. Articles by Taubert, M. Search for Related Content PubMed PubMed Citation Articles by Back, I. Articles by Taubert, M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB CYCLIZINE FLUOXETINE HALOPERIDOL OXYCODONE Medline Plus Health Information Palliative Care Social Bookmarking                         What's this?

A case report : Akathisia and an unusual symptomatic treatment

Palliative Medicine, Y Bwthyn Palliative Care Unit, Pontypridd, Wales, ian.back{at}pallcare.info

Mark Taubert

Palliative Medicine, Ty Olwen Palliative Care Unit, Morriston Hospital, Swansea

We present a case of medication-induced akathisia in a 47-year-old woman with metastatic carcinoma of the ovary. Severe pacing and restlessness started after commencing a subcutaneous infusion with cyclizine 150mg, haloperidol 2.5 mg and oxycodone 20 mg. She was also taking levomepromazine and fluoxetine orally at the time. By making changes to her medication, her symptoms resolved gradually. During the time of convalescence, she gained great symptomatic relief from using exercise pedals and it allowed her to go about usual everyday activities, such as eating and reading, while continuously treading the pedals. Palliative Medicine 2007; 21 : 713—715

Key Words: akathisia • exercise • fluoxetine • haloperidol • restlessness

References

• Hamilton MS, Opler LA Akathisia, suicidality, and fluoxetine . J Clin Psychiatry 1992; 53(11): 401—6 .[Web of Science][Medline] [Order article via Infotrieve]
• Lane RM SSRI-induced extrapyramidal side-effects and akathisia: implications for treatment . J Psychopharmacol 1998; 12(2): 192—214 .[Abstract/Free Full Text]
• Janno S., Holi M., Tuisku K., Wahlbeck K. Prevalence of neuroleptic-induced movement disorders in chronic schizophrenia inpatients . Am J Psychiatry 2004; 161(1): 160—3 .[Abstract/Free Full Text]
• Kim JH, Byun HJ Prevalence and characteristics of subjective akathisia, objective akathisia, and mixed akathisia in chronic schizophrenic subjects . Clin Neuropharmacol 2003; 26(6): 312—6 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Gattera JA, Charles BG, Williams GM, Cavenagh JD, Smithurst BA, Luchjenbroers J. A retrospective study of risk factors of akathisia in terminally ill patients . J Pain Symptom Manage 1994; 9(7): 454—61 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Joint Formulary Committee. British national formulary, 51st edition. British Medical Association and Royal Pharmaceutical Society of Great Britain , 2006.
• Holley FO, Magliozzi JR, Stanski DR, Lombrozo L., Hollister LE Haloperidol kinetics after oral and intravenous doses . Clin Pharmacol Ther 1983; 33(4): 477—84 .[Web of Science][Medline] [Order article via Infotrieve]
• Magliozzi JR, Hollister LE Elimination half-life and bioavailability of haloperidol in schizophrenic patients . J Clin Psychiatry 1985; 46(1): 20—1 .[Web of Science][Medline] [Order article via Infotrieve]
• Darby JK, Pasta DJ, Dabiri L., Clark L., Mosbacher D. Haloperidol dose and blood level variability: toxicity and interindividual and intraindividual variability in the nonresponder patient in the clinical practice setting . J Clin Psychopharmacol 1995; 15(5): 334—40 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Froemming JS, Lam YW, Jann MW, Davis CM pharmacokinetics of haloperidol . Clin Pharmacokinet 1989; 17(6): 396—423 .[Web of Science][Medline] [Order article via Infotrieve]
• Caley CF Extrapyramidal reactions and the selective serotonin-reuptake inhibitors . Ann Pharmacother 1997; 31(12): 1481—9 .[Abstract]
• Leo RJ Movement disorders associated with the serotonin selective reuptake inhibitors . J Clin Psychiatry 1996; 57(10): 449—54 .[Web of Science][Medline] [Order article via Infotrieve]
• Lal S., Nair NP, Cecyre D., Quirion R. Levomepromazine receptor binding profile in human brain—implications for treatment-resistant schizophrenia . Acta Psychiatr Scand 1993; 87(6): 380—3 .[Web of Science][Medline] [Order article via Infotrieve]
• Eisenchlas JH, Garrigue N., Junin M., De Simone GG Low-dose levomepromazine in refractory emesis in advanced cancer patients: an open-label study . Palliat Med 2005; 19(1): 71—5 .[Abstract/Free Full Text]
• Kennett A., Hardy J., Shah S., A'Hern R. An open study of methotrimeprazine in the management of nausea and vomiting in patients with advanced cancer . Supp Care Cancer 2005; 13(9): 715—21 .[CrossRef]
• Skinner J., Skinner A. Levomepromazine for nausea and vomiting in advanced cancer . Hosp Med 1999; 60(8): 568—70 .[Web of Science][Medline] [Order article via Infotrieve]
• Hansen L. A critical review of akathisia, and its possible association with suicidal behaviour . Hum Psychopharmacol 2001; 16(7): 495—505 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Lima AR, Bacalcthuk J., Barnes TR, Soares-Weiser K. Central action beta-blockers versus placebo for neuroleptic-induced acute akathisia . Cochrane Database Syst Rev 2004; (4): CD001946.
• Lima AR, Weiser KV, Bacaltchuk J., Barnes TR Anticholinergics for neuroleptic-induced acute akathisia . Cochrane Database Syst Rev 2004; (1): CD003727.
• 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(3): 305—8 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• 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(11): 1071—7 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Ranjan S., Chandra PS, Chaturvedi SK, Prabhu SC, Gupta A. Atypical antipsychotic-induced akathisia with depression: therapeutic role of mirtazapine (April) . Ann Pharmacother 2006; 40(4): 771—4 .[Abstract/Free Full Text]
• He N., Zhang WQ, Shockley D., Edeki T. Inhibitory effects of H1-antihistamines on CYP2D6- and CYP2C9-mediated drug metabolic reactions in human liver microsomes . Eur J Clin Pharmacol 2002; 57(12): 847—51 .[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Suzuki A., Yasui-Furukori N., Mihara K., Kondo T., Furukori H., Inoue Y., Kaneko S., Otani K. Histamine H1-receptor antagonists, promethazine and homochlorcyclizine, increase the steady-state plasma concentrations of haloperidol and reduced haloperidol. There Drug Monit 2003; 25(2): 192—6 .[CrossRef]

Palliative Medicine, Vol. 21, No. 8, 713-715 (2007)
DOI: 10.1177/0269216307083598


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Web of Science (2) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Back, I. Articles by Taubert, M. Search for Related Content PubMed PubMed Citation Articles by Back, I. Articles by Taubert, M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB CYCLIZINE FLUOXETINE HALOPERIDOL OXYCODONE Medline Plus Health Information Palliative Care Social Bookmarking                         What's this?