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J Psychopharmacol. 2012 Jun;26(6):887-90. doi: 10.1177/0269881111405363. Epub 2011 Jul 11.

Amisulpride-induced acute akathisia in OCD: an example of dysfunctional dopamine-serotonin interactions?

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  • 1Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.


We report about a clinical observation in a well-characterized group of patients with obsessive-compulsive disorder (OCD) during an experimental medicine study in which a single dose of amisulpride (a selective D₂/₃ antagonist) was administered. Almost half of the OCD patients, in particular those with less severe obsessive-compulsive symptoms, experienced acute akathisia in response to the amisulpride challenge. This unexpectedly high incidence of akathisia in the selective serotonin reuptake inhibitor (SSRI)-treated patients with OCD suggests that individual differences in dopamine-serotonin interactions underlie the clinical heterogeneity of OCD, and may thus explain the insufficiency of SSRI monotherapy in those patients not experiencing a satisfactory outcome in symptom reduction. We further speculate about the neuropathology possibly underlying this clinical observation and outline a testable hypothesis for future molecular imaging studies.

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