ORIGINAL ARTICLESTreatment of Neuroleptic-Induced Akathisia With the 5-HT2A Antagonist TrazodoneStryjer, Rafael*; Strous, Rael D.*†; Bar, Faina*†; Poyurovsky, Michael‡; Weizman, Abraham†§; Kotler, Moshe*†Author Information *Beer Yaakov Mental Health Center, †Sackler Faculty of Medicine, Tel Aviv University, ‡Tirat Carmel Mental Health Center, §Geha Mental Health Center, Israel Address correspondence and reprint requests to Dr. Rael Strous, Beer Yaakov Mental Health Center, PO Box 1, Beer Yaakov 70350, Israel; e-mail: email@example.com Clinical Neuropharmacology: May-June 2003 - Volume 26 - Issue 3 - p 137-141 Buy Abstract Akathisia is a common and distressful extrapyramidal adverse side effect usually resulting from the use of antipsychotic medications. Early management of akathisia is important because it may be associated with poor treatment response and medication noncompliance. Unfortunately many patients fail to respond to standard management of akathisia. In addition to dopaminergic mechanisms, it has been hypothesized that serotonin may play a prominent role in the pathophysiology of akathisia. Trazodone is an antidepressant agent demonstrating prominent serotonergic antagonistic properties. This open-label pilot study investigates the efficacy of trazodone in the management of akathisia. Nine female patients with a score of at least “mild akathisia” on the Barnes Akathisia Scale, and receiving a stable dose of antipsychotic medication, were administered trazodone, titrated up to a dosage of 100 mg/day over a period of 5 days. The patients demonstrated marked improvement in symptoms of akathisia. In addition, some improvement was noted in symptomatology of anxiety, depression, and psychosis. These observations suggest the use of trazodone as a beneficial and relatively safe medication for the treatment of antipsychotic medication-induced akathisia. Further study in the context of a double-blind, placebo-controlled trial is mandated to substantiate these preliminary findings. © 2003 Lippincott Williams & Wilkins, Inc.