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Idazoxan and Response to Typical Neuroleptics in Treatment-Resistant Schizophrenia

Comparison with the Atypical Neuroleptic, Clozapine

Published online by Cambridge University Press:  02 January 2018

Robert E. Litman ,
Tung-Ping Su ,
William Z. Potter ,
Walter W. Hong  and
David Pickar
Robert E. Litman*
Affiliation:
National Institute of Mental Health, Experimental Therapeutics Branch, Bethesda
Tung-Ping Su
Affiliation:
National Institute of Mental Health, Experimental Therapeutics Branch, Bethesda
William Z. Potter
Affiliation:
National Institute of Mental Health, Experimental Therapeutics Branch, Bethesda
Walter W. Hong
Affiliation:
National Institute of Mental Health, Experimental Therapeutics Branch, Bethesda
David Pickar
Affiliation:
National Institute of Mental Health, Experimental Therapeutics Branch, Bethesda
*
Dr R. E. Litman, National Institute of Mental Health, Experimental Therapeutics Branch, Section on Clinical Studies, NIH 10/4N212, 10 Center DR MSC 1380, Bethesda MD 20892-1380
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Abstract

Background

We investigated whether antagonism of α2 adrenergic receptors would augment treatment response in schizophrenia, by administering idazoxan, an α2 antagonist drug, to treatment-resistant patients on typical neuroleptics.

Method

Seventeen hospitalised treatment-resistant patients with DSM–III–R schizophrenia or schizoaffective disorder were studied on typical neuroleptic treatment, on treatment with idazoxan plus typical neuroleptic, and after discontinuation of idazoxan, in fixed, non-random order, and under double-blind, placebo-controlled conditions.

Results

The addition of idazoxan to fluphenazine treatment resulted in significant reductions of global psychosis and total, positive and negative symptoms on the Brief Psychiatric Rating Scale, compared to neuroleptic treatment alone. Symptom improvement significantly correlated with idazoxan-induced changes in indices of noradrenergic function. In a subgroup of patients, idazoxan plus typical neuroleptic treatment compared favourably with clozapine treatment, when both were compared to typical neuroleptic treatment alone.

Conclusions

The antagonism of α2 receptors augmented therapeutic response to typical neuroleptic treatment in treatment-resistant patients with schizophrenia. This antagonism may contribute to clozapine's superior antipsychotic effects.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 5 , May 1996 , pp. 571 - 579
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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