- Email: [email protected]
Fluoxetine addition to haloperidol treatment in chronic schizophrenics
2325
Schizophrenia
BIOL. PSYCHIATRY 1997:42: 15-2975
187-91 Clinical trial on antipsychotic effects of the sigma ligand panamesln (EMD 57445) In schizophrenia A. Steiger, A.M. Frieboes, H. Murck. K. Wiedemann. Max Planck Institute of Psychiatry. Dept. of Psychiatry. Munich. Germany The sigma (<7) receptor has been proposed as a target of neuroleptic drugs. Preclinical data suggest that panamesine (EMO 57445), a novel IT ligand, has antipsychotic effects and is free of side effects related to the extrapyramidal motoric system (EPMS). Here we report the results of exploratory studies aimed at determining the appropriate dose range and the safety of panamesine in patients with an acute episode 01 schizophrenia. The first trial with 4 patients revealed Insufficient clinical efficacy of a protocol where the dally dosage was Increased stepwise from 7.5 mg dUring the first week, up to 30 mg dUrlng the third and lourth weeks. In a second set of trials, 12 patients received 15 mg at the beginning, this being increased up to 60 mg/day within three days and then maintained at this level lor .. weeks. According to the decrease in the Brief Psychiatric Rating Stale score by at least 50%, 5 patients were judged as responders, whereas 6 patients showed only a slight improvement, and 1 deterlorated. In all patients prolactin levels increased during treatment, probably due to an active metabolite with weak dopamine-2-receptor antagonistic effects. No major side effects occurred, In particular, no EPMS symptoms were seen.
88. Schizophrenia
188-21 Smoking cessation treatment In schizophrenia J. Addington, O. Addington, N. el-Guebaly, W. Campbell, O. Hodgins. Department of Psychiatry. University of Calgary. Calgary. Alberta. Canada Schizophrenia patients smoke more than the average population and other psychiatric groups. The cognitive, social and symptomatic difficulties that many schizophrenia patients experience, suggest that existing cessation programs are not appropriate for them. This was an open trial to assess the effIcacy and leasibility 01 a smoking program that was designed to meet the specific needs 01 this population and to assess the suitability 01 transdermal nicotine lor this group. Methods: 40 schizophrenia outpatients who wanted to stop smoking partlclpated. Four separate groups with to subjects were held for 7 ses• sions. Adherence to the modified program was monitored. Assessments Included the Positive and Negative Syndrome Stale, the Simpson-Angus Scale, nicotine dependence, and urine cotinine were administered pre-group, post-group and at 3 months. Results: Sixteen (40%) had stopped smoklng post-group and seven (18%) remained abstinent at three months. These changes were significant (p < 0.001) and are comparable to quit rates lor non-psychiatric populations. There was signifiCatlt Improvement of nicotine dependence (p < 0.001) and no changes In symptoms. Most 01 those who quit used transdermal nicotine. These results suggest that stopping smoking is possible lor Individuals with schizophrenia especially If the treatment Is specifically designed for this population.
188-31 Arachidonic and docosahexaenolc acid levels In
blood In schizophrenics who do and do not flush to oral niacin
O.F. Horrobin, K.S. Vaddadi, A.I.M. Glen, S. Cooper, J. Fahey, J. Rybakowskl. J. Shay. Scotia Res8llrch Institute. Stirling. Scotland 200 mg niacin given orally causes marked laclal flushing because of release of arachidonic acid and its conversion to prostaglandin 02' Normal individu• als, bipolar patients and depressed patients allliush. 20-40% 01 unselected schizophrenic patients do not flush in this test and a preponderance of those who do not flush exhibit the negative syndrome. 69 schizophrenics from Scotland, Ireland, Poland and Australia were selected on clinical grounds as having a predominantly negative syndrome. 33 flushed in response to oral niacin and 36 did not There were no important differences In drug treatment between the groups, indicating that flushing status was not related to drugs. However, red cell AA and OHA levels were significantly decreased and
plasma AA and OHA levels were Increased In the non-llushers as compared to the flushers. Both groups showed significantly decreased red cell AA and OHA as compared to control. This study confirms again that schiZophrenics have reduced red cell membrane AA and OHA levels and demonstrates that the abnormality Is more severe in schizophrenics who do not flush In response to oral niacin.
188-41 Clinical effects of perosplrone on schizophrenia: A double blind study with mosapramlne
Y. Kudo. HarukJ Hospital, Osaka. Japan Clinical efficacy and safety of a 5-HT2ID2 antagonist, perospirone (PER) In comparison with mosapramine (MOS) were Investigated In schizophrenic patients (ICD-10, OSM-III-R criteria). Methods: The psychiatric symptoms were evaluated by BPAS and PANSS. Side effects were recorded on the side effect monitorlng scale in Japan. Doses 01 study medications dUring 8 weeks were permitted between 12 to 48 mg and 75 to 300 mg of PER and MOS, respectively. All patients (16t cases) were randomly assigned to two groups in double-blind fashion. Aesults: Anergia and anxlety-depression cluster-scores ot SPAS were more markedly decreased from week to week by PEA than MOS. They also decreased total scores, thought disturbances, activation and hostility cluster-scores In BPRS. Total scores and positive. negative and GPS sub• scale-scores 01 PANSS were similarly decreased after treatment of PER and MOS. Extrapyramidal symptoms appeared 01 46% and 56% patients with PER and MOS, respectively. Those symptoms In most 01 patients disappeared after antiparklnsonlan medication. A new SOA, PER may have a broad clinical spectrum on symptoms in patients with schizophrenia.
18S-51 chronic Fluoxetine addition to haloperidol treatment In schizophrenics M.S. Lee. C.S. Han, K.S. Won, J.W. Kim, 0.1. Kwak. Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea ObJectives: To evaluate the effects ollluoxeline addition to haloperidol. we carried out a double-blind. placebo controlled study. Method: We assigned 38 chronic schizophrenics (OSM-III-A) randomly to placebo group and lIuoxetlne group In a double blind lashlon. The subjects of each groups received f1uoxetine 20 mg or placebo for 8 weeks in addition to their haloperidol regimen. Psychopathology and extrapyramidal symptoms are assessed by the Positive and Negative Syndrome Scale (PANSS). Clinical Global Scale (CGI). Simpson-Angus Scale at 5 polnt; baseline, 2. 4, 6, 8 weeks 01 the study. AelullS: 38 patients have completed the study during 8weeks. There were no significant differences between groups and no significant changes according to the times in the PANSS, CGI scores. There were no significant changes 01 the Simpson-Angus Stale scores. Conclullon: This placebo controlled study showed no significant effects of nuoxetine on negative, positlve, and extrapyramidal symptoms In chronic schizophrenics.
188-61 schizophrenic Arginine-vasopressin secretion In non-medicated patients T. Kishimoto. N. Shlmayoshl, K. Knera, H. Ohsawa, Y. Inoue. M. Hirai, J. llda, Y. Kimura, Y. Ohgitani, T. Ohshiro, A. MIzuta, T. Miyamoto. Dep. of ~ych~try.~~Med~U~~ty,~~~
The aim of this study Is to elucidate the arglnle-vasopressln secretion (VP) In non-medicated schizophrenic patients. Methods: Plasma VP and osmolality were measured belore and alter oral water loading In 14 normal volunteers, 20 non-medicated and 27 medicated schizophrenic palients with psychotic drugs. In the 13 non-medicated pa_ tients, water loading test was performed twice, before and dUring medication. AesullS: 1; Simple regression analysis did not show significant differences in VP secrellon between the controls and the non-medicated patients. The sensitivlty 01 VP secretion response to osmOlality change In the medicated patients was lower than In the normaJ controls. 2; Factor analysis and multiple regressIon analysis In the non-medlcated patients revealed the association of BPRS scores to VP levels. VP levels were related positively to the acute psychotic factor and negatively to the conceptual disorganization and grandiosity factor.
Schizophrenia
BIOL. PSYCHIATRY 1997:42: 15-2975
187-91 Clinical trial on antipsychotic effects of the sigma ligand panamesln (EMD 57445) In schizophrenia A. Steiger, A.M. Frieboes, H. Murck. K. Wiedemann. Max Planck Institute of Psychiatry. Dept. of Psychiatry. Munich. Germany The sigma (<7) receptor has been proposed as a target of neuroleptic drugs. Preclinical data suggest that panamesine (EMO 57445), a novel IT ligand, has antipsychotic effects and is free of side effects related to the extrapyramidal motoric system (EPMS). Here we report the results of exploratory studies aimed at determining the appropriate dose range and the safety of panamesine in patients with an acute episode 01 schizophrenia. The first trial with 4 patients revealed Insufficient clinical efficacy of a protocol where the dally dosage was Increased stepwise from 7.5 mg dUring the first week, up to 30 mg dUrlng the third and lourth weeks. In a second set of trials, 12 patients received 15 mg at the beginning, this being increased up to 60 mg/day within three days and then maintained at this level lor .. weeks. According to the decrease in the Brief Psychiatric Rating Stale score by at least 50%, 5 patients were judged as responders, whereas 6 patients showed only a slight improvement, and 1 deterlorated. In all patients prolactin levels increased during treatment, probably due to an active metabolite with weak dopamine-2-receptor antagonistic effects. No major side effects occurred, In particular, no EPMS symptoms were seen.
88. Schizophrenia
188-21 Smoking cessation treatment In schizophrenia J. Addington, O. Addington, N. el-Guebaly, W. Campbell, O. Hodgins. Department of Psychiatry. University of Calgary. Calgary. Alberta. Canada Schizophrenia patients smoke more than the average population and other psychiatric groups. The cognitive, social and symptomatic difficulties that many schizophrenia patients experience, suggest that existing cessation programs are not appropriate for them. This was an open trial to assess the effIcacy and leasibility 01 a smoking program that was designed to meet the specific needs 01 this population and to assess the suitability 01 transdermal nicotine lor this group. Methods: 40 schizophrenia outpatients who wanted to stop smoking partlclpated. Four separate groups with to subjects were held for 7 ses• sions. Adherence to the modified program was monitored. Assessments Included the Positive and Negative Syndrome Stale, the Simpson-Angus Scale, nicotine dependence, and urine cotinine were administered pre-group, post-group and at 3 months. Results: Sixteen (40%) had stopped smoklng post-group and seven (18%) remained abstinent at three months. These changes were significant (p < 0.001) and are comparable to quit rates lor non-psychiatric populations. There was signifiCatlt Improvement of nicotine dependence (p < 0.001) and no changes In symptoms. Most 01 those who quit used transdermal nicotine. These results suggest that stopping smoking is possible lor Individuals with schizophrenia especially If the treatment Is specifically designed for this population.
188-31 Arachidonic and docosahexaenolc acid levels In
blood In schizophrenics who do and do not flush to oral niacin
O.F. Horrobin, K.S. Vaddadi, A.I.M. Glen, S. Cooper, J. Fahey, J. Rybakowskl. J. Shay. Scotia Res8llrch Institute. Stirling. Scotland 200 mg niacin given orally causes marked laclal flushing because of release of arachidonic acid and its conversion to prostaglandin 02' Normal individu• als, bipolar patients and depressed patients allliush. 20-40% 01 unselected schizophrenic patients do not flush in this test and a preponderance of those who do not flush exhibit the negative syndrome. 69 schizophrenics from Scotland, Ireland, Poland and Australia were selected on clinical grounds as having a predominantly negative syndrome. 33 flushed in response to oral niacin and 36 did not There were no important differences In drug treatment between the groups, indicating that flushing status was not related to drugs. However, red cell AA and OHA levels were significantly decreased and
plasma AA and OHA levels were Increased In the non-llushers as compared to the flushers. Both groups showed significantly decreased red cell AA and OHA as compared to control. This study confirms again that schiZophrenics have reduced red cell membrane AA and OHA levels and demonstrates that the abnormality Is more severe in schizophrenics who do not flush In response to oral niacin.
188-41 Clinical effects of perosplrone on schizophrenia: A double blind study with mosapramlne
Y. Kudo. HarukJ Hospital, Osaka. Japan Clinical efficacy and safety of a 5-HT2ID2 antagonist, perospirone (PER) In comparison with mosapramine (MOS) were Investigated In schizophrenic patients (ICD-10, OSM-III-R criteria). Methods: The psychiatric symptoms were evaluated by BPAS and PANSS. Side effects were recorded on the side effect monitorlng scale in Japan. Doses 01 study medications dUring 8 weeks were permitted between 12 to 48 mg and 75 to 300 mg of PER and MOS, respectively. All patients (16t cases) were randomly assigned to two groups in double-blind fashion. Aesults: Anergia and anxlety-depression cluster-scores ot SPAS were more markedly decreased from week to week by PEA than MOS. They also decreased total scores, thought disturbances, activation and hostility cluster-scores In BPRS. Total scores and positive. negative and GPS sub• scale-scores 01 PANSS were similarly decreased after treatment of PER and MOS. Extrapyramidal symptoms appeared 01 46% and 56% patients with PER and MOS, respectively. Those symptoms In most 01 patients disappeared after antiparklnsonlan medication. A new SOA, PER may have a broad clinical spectrum on symptoms in patients with schizophrenia.
18S-51 chronic Fluoxetine addition to haloperidol treatment In schizophrenics M.S. Lee. C.S. Han, K.S. Won, J.W. Kim, 0.1. Kwak. Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea ObJectives: To evaluate the effects ollluoxeline addition to haloperidol. we carried out a double-blind. placebo controlled study. Method: We assigned 38 chronic schizophrenics (OSM-III-A) randomly to placebo group and lIuoxetlne group In a double blind lashlon. The subjects of each groups received f1uoxetine 20 mg or placebo for 8 weeks in addition to their haloperidol regimen. Psychopathology and extrapyramidal symptoms are assessed by the Positive and Negative Syndrome Scale (PANSS). Clinical Global Scale (CGI). Simpson-Angus Scale at 5 polnt; baseline, 2. 4, 6, 8 weeks 01 the study. AelullS: 38 patients have completed the study during 8weeks. There were no significant differences between groups and no significant changes according to the times in the PANSS, CGI scores. There were no significant changes 01 the Simpson-Angus Stale scores. Conclullon: This placebo controlled study showed no significant effects of nuoxetine on negative, positlve, and extrapyramidal symptoms In chronic schizophrenics.
188-61 schizophrenic Arginine-vasopressin secretion In non-medicated patients T. Kishimoto. N. Shlmayoshl, K. Knera, H. Ohsawa, Y. Inoue. M. Hirai, J. llda, Y. Kimura, Y. Ohgitani, T. Ohshiro, A. MIzuta, T. Miyamoto. Dep. of ~ych~try.~~Med~U~~ty,~~~
The aim of this study Is to elucidate the arglnle-vasopressln secretion (VP) In non-medicated schizophrenic patients. Methods: Plasma VP and osmolality were measured belore and alter oral water loading In 14 normal volunteers, 20 non-medicated and 27 medicated schizophrenic palients with psychotic drugs. In the 13 non-medicated pa_ tients, water loading test was performed twice, before and dUring medication. AesullS: 1; Simple regression analysis did not show significant differences in VP secrellon between the controls and the non-medicated patients. The sensitivlty 01 VP secretion response to osmOlality change In the medicated patients was lower than In the normaJ controls. 2; Factor analysis and multiple regressIon analysis In the non-medlcated patients revealed the association of BPRS scores to VP levels. VP levels were related positively to the acute psychotic factor and negatively to the conceptual disorganization and grandiosity factor.