Clin Psychopharmacol Neurosci.  2018 Aug;16(3):346-348. 10.9758/cpn.2018.16.3.346.

Successful Management of Clozapine-induced Akathisia with Gabapentin Enacarbil: A Case Report

• Takeshima
• Ishikawa H
• Kikuchi Y
• Kanbayashi T
• Shimizu T

• KMID: 2419991
• DOI: http://doi.org/10.9758/cpn.2018.16.3.346

Abstract

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.

Keyword

Akathisia; drug induced; Antipsychotic agents; Clozapine; Gabapentin; Gabapentin enacarbil; Restless legs syndrome

MeSH Terms

Adult
Antipsychotic Agents
Benzodiazepines
Biperiden
Clozapine
Female
Humans
Prognosis
Psychomotor Agitation*
Restless Legs Syndrome
Schizophrenia
Antipsychotic Agents
Benzodiazepines
Biperiden
Clozapine