ABSTRACT
BACKGROUND: Although propranolol has been documented to be useful in treatment of neuroleptic-induced akathisia, preliminary anecdotal reports on the efficacy of nadolol in treatment of this condition are contradictory. METHOD: To evaluate the efficacy of nadolol in treatment of this condition, a double-blind, placebo-controlled trial was conducted in 20 psychiatric inpatients. Patients with akathisia of at least moderate severity were randomly assigned to receive nadolol 40 to 80 mg/day or placebo. Patients were rated daily for 4 days, then every other day for 15 days by means of the Extrapyramidal Symptom Rating Scale. RESULTS: No significant differences were found between or within groups in subjective restlessness scores. In objective akathisia scores, there were no significant differences between groups; however, beginning at Day 9, both groups showed significant improvement compared with Day 1. There was no difference between groups in number of responders. CONCLUSIONS: The authors' data do not support the efficacy of nadolol in the treatment of neuroleptic-induced akathisia and do not provide support for a peripheral site of action for beta-blockers in treatment of this condition.
Subject(s)
Antipsychotic Agents/adverse effects , Nadolol/therapeutic use , Psychomotor Agitation/drug therapy , Adolescent , Adult , Aged , Akathisia, Drug-Induced , Antipsychotic Agents/therapeutic use , Basal Ganglia Diseases/chemically induced , Basal Ganglia Diseases/drug therapy , Double-Blind Method , Drug Administration Schedule , Female , Hospitalization , Humans , Male , Middle Aged , Nadolol/administration & dosage , PlacebosSubject(s)
Bronchodilator Agents/adverse effects , Calcium Channel Blockers/adverse effects , Expectorants/adverse effects , Mental Disorders/chemically induced , Nasal Decongestants/adverse effects , Parasympatholytics/adverse effects , Adolescent , Adult , Albuterol/adverse effects , Child , Cromolyn Sodium/adverse effects , Dextromethorphan/adverse effects , Ephedrine/adverse effects , Humans , Iodides/adverse effects , Phenylpropanolamine/adverse effects , Psychoses, Substance-Induced/etiology , Theophylline/adverse effectsABSTRACT
In Part IV of a series on the use of psychoactive drugs, the appropriate use of antianxiety agents is discussed. A step-wise approach which focuses on practical methods of managing anxiety is formulated. A framework is presented as a guide to clinicians treating anxiety symptoms in a variety of conditions.
