Fluvoxamine for aripiprazole-associated akathisia in patients with schizophrenia a potential role of sigma-1 receptors.docVIP

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Fluvoxamine for aripiprazole-associated akathisia in patients with schizophrenia a potential role of sigma-1 receptors.doc

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Fluvoxamine for aripiprazole-associated akathisia in patients with schizophrenia a potential role of sigma-1 receptors

FuruseandHashimotoAnnalsofGeneralPsychiatry2010,9:11 /content/9/1/11 CASE REPORT OpenAccess Fluvoxamineforaripiprazole-associatedakathisia inpatientswithschizophrenia:apotentialroleof sigma-1receptors TsutomuFuruse1*,KenjiHashimoto2 Abstract Background:Second-generationantipsychoticdrugshavebeenreportedtocausefewerincidencesof extrapyramidalsideeffects(EPSs)thantypicalantipsychoticdrugs,butadverseeventssuchasakathisiahavebeen observedevenwithatypicalantipsychoticdrugs.Althoughunderstandingofthepathophysiologyofakathisia remainslimited,itseemsthatacomplexinterplayofseveralneurotransmittersystemsmightplayaroleinits pathophysiology.Theendoplasmicreticulumproteinsigma-1receptorsareshowntoregulateanumberof neurotransmittersystemsinthebrain. Methods:Wereportontwocasesinwhichmonotherapyoftheselectiveserotoninreuptakeinhibitorandsigma- 1receptoragonistfluvoxaminewaseffectiveinamelioratingtheakathisiaofpatientswithschizophreniatreated withtheantipsychoticdrugaripiprazole. Results:TheglobalscoreontheBarnesAkathisiaScaleinthetwopatientswithschizophreniatreatedwith aripiprazoledecreasedafterfluvoxaminemonotherapy. Conclusion:Doctorsmaywishtoconsiderfluvoxamineasanalternativeapproachintreatingakathisiaassociated withantipsychoticdrugssuchasaripiprazole. Background thatacomplexinterplayofseveralneurotransmittersys- Second-generation antipsychotic drugs have been tems (for example, dopamine, acetylcholine, norepi- reported to cause fewer incidences of extrapyramidal nephrine, serotonin, g-aminobutyric acid (GABA), and sideeffects (EPSs)thantypical antipsychotic drugs,but neuropeptides) underlies its complex pathophysiology adverse events such as akathisia have been observed evenwithatypicalantipsychotic drugs.Akathisiaisone [1,2]. Theendoplasmicreticulumproteinsigma-1receptors of the most common and distressing EPSs of antipsy- play akey role inCa2+ signalling andcell survival, and chotic drugs [1,2]. The development of akathisia can have been shown to regulate a number