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KMID : 1009020180160030346
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Clinical Psychopharmacology and Neuroscience
2018 Volume.16 No. 3 p.346 ~ p.348
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Successful Management of Clozapine-induced Akathisia with Gabapentin Enacarbil: A Case Report
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Takeshima Masahiro
Ishikawa Hiroyasu
Kikuchi Yuka
Kanbayashi Takashi
Shimizu Tetsuo
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Abstract
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The management of clozapine (CLZ)-induced adverse events affects patient prognoses. Akathisia is a relatively rare adverse event related to CLZ administration and thus the management of this syndrome is not well established. Here, we report a case of treatment-resistant schizophrenia wherein CLZ-induced akathisia was successfully managed with gabapentin enacarbil (GE). The patient was a 39-year-old woman who had been treated with atypical antipsychotics other than CLZ for three years with poor tolerability. Initiation of CLZ (400 mg/day) attenuated her psychotic symptoms, but was followed by moderate akathisia. Neither benzodiazepines nor biperiden improved the akathisia; however, akathisia was finally diminished with co-administration of GE. GE facilitated a dosage increase in CLZ (450 mg/day) for the improved management of pyschotic symptoms, and thus indirectly contributed to treatment of the patient’s schizophrenia. We suggest that GE is a useful candidate for the management of CLZ-induced akathisia. The improved management of treatment-induced akathisia and other adverse events can extend the potential application of CLZ for treatment-resistant schizophrenia.
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KEYWORD
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Akathisia, drug induced, Antipsychotic agents, Clozapine, Gabapentin, Gabapentin enacarbil, Restless legs syndrome
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