Intravenous biperiden in akathisia: An open pilot study

Citation
S. Hirose et Cr. Ashby, Intravenous biperiden in akathisia: An open pilot study, INT J PSY M, 30(2), 2000, pp. 185-194
Citations number
32
Categorie Soggetti
Psychiatry,"Clinical Psycology & Psychiatry
Journal title
INTERNATIONAL JOURNAL OF PSYCHIATRY IN MEDICINE
ISSN journal
00912174 → ACNP
Volume
30
Issue
2
Year of publication
2000
Pages
185 - 194
Database
ISI
SICI code
0091-2174(2000)30:2<185:IBIAAO>2.0.ZU;2-J
Abstract
Objective: Antipsychotic-induced akathisia can be distressing and unendurab le for prolonged periods. It has been shown that intramuscular biperiden is a relatively rapid and effective treatment for akathisia. However, the int ravenous administration of biperiden may provide a more rapid effect, altho ugh this remains to be definitively proven. Method; The subjects obtained f or this study met the diagnostic criteria for schizophrenia as defined by t he Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The ther apeutic effect of i.v. and i.m. biperiden was studied in an open clinical t rial in twenty-three (12 male and 11 female) patients who developed antipsy chotic-induced acute akathisia as defined by the research criteria of the D SM-IV. Following the development of akathisia, 5 mg of biperiden was intrav enously injected in seventeen patients and intramuscularly in six patients. The therapeutic effect of biperiden on akathisia was clinically assessed b y using the rating scale of Barnes. Results: Following i.v. administration on biperiden, the meantime to onset and maximum effect occurred 1.6 (SD = 1 .9) and 9.2 minutes (SD = 6.0), respectively. Furthermore, at the time of m aximal effect, akathisia was completely ameliorated in all patients. The si de effects reported were mild and transient. Following i.m. administration, the mean time to onset and maximum effect were 30.5 (SD = 5.9) and 50 minu tes (SD = 7.4), respectively. Thus, the time to maximal effect was signific antly less (40 minutes) alter i.v. compared to i.m. administration. Conclus ion: These results suggest that i.v. administration of 5 mg of biperiden co uld be used to provide a rapid and effective treatment for patients with se vere akathisia.