Efficacy of Low-Dose Metoprolol in Neuroleptic-Induced Akathisia

Abstract

Recent studies have shown that the β-blockers can be effective treatments for neuroleptic-induced akathisia. However, the relative contributions of β-1 versus β-2 blockade to the therapeutic effect of β-blockers remains unclear. We treated nine patients who had neuroleptic-induced akathisia with low doses (25–100 mg/day) of the β-blocker metoprolol. At these doses metoprolol causes selective blockade of β-1 receptors. Seven patients improved after metoprolol; no further substantial changes were seen after subsequent treatment with propranolol. This finding suggests that neuroleptic-induced akathisia can be improved by selective β-1 blockade.