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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1106

Treatment of antipsychotic-induced akathisia: short-term evidence, long-term uncertainty

TREATING ANTIPSYCHOTIC-INDUCED AKATHISIA: SHORT-TERM EVIDENCE, LONG-TERM UNCERTAINTY

Although evidence supports the short-term efficacy of propranolol and mirtazapine, the available data are insufficient to establish a preferred first-line agent, and there is no evidence beyond one month.

The aim of the study is to evaluate the pharmacological evidence for propranolol and mirtazapine in antipsychotic-induced akathisia and to address the unresolved question of first-line treatment selection. A targeted PubMed search covering adult human studies was conducted, prioritizing randomized trials, reviews, meta-analyses, and guidelines with direct clinical relevance. Propranolol, a beta-blocker, is the most extensively studied individual agent, has the broadest historical evidence base, and demonstrates short-term benefit over placebo. Mirtazapine, which has serotonin 2A antagonist activity, has a smaller randomized evidence base; its short-term efficacy is supported by two placebo-controlled trials, one of which lasted seven days and also included a propranolol arm. Direct comparative evidence is limited: both active treatments were superior to placebo, but neither demonstrated clear superiority over the other. Network meta-analyses report signals of short-term benefit for serotonin 2A antagonists and beta-blockers but do not establish clear superiority among active treatments. There are no studies of treatment lasting longer than one month, and the available literature is limited by small samples, short follow-up, and limited diversity. In clinical practice, treatment should be individualized according to the patient, contraindications, tolerability, and clinical context. Future studies should use larger, adequately powered, head-to-head, long-term designs encompassing different age groups, settings, and cultures.

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