Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-17T20:16:07.365Z Has data issue: false hasContentIssue false

One-year, low-dose neuroleptic study of in-patients with chronic schizophrenia characterised by persistent negative symptoms

Amisulpride v. haloperidol

Published online by Cambridge University Press:  02 January 2018

Jeremy C. Speller*
Affiliation:
Plymouth Nuffield Clinic, Plymouth PL4 8NQ
Thomas R. E. Barnes
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, London
David A. Curson
Affiliation:
Cognitive Neuropsychiatry Unit, Mental Health Research Institute and The Royal Melbourne Hospital, Parkville, Victoria, Australia
Christos Pantelis
Affiliation:
Synthélabo Recherche, Bagneux, France
J. L. Alberts
Affiliation:
Synthélabo Recherche, Bagneux, France
*
Dr Jeremy C. Speller, Plymouth Nuffield Clinic, Lipson Road, Plymouth, Devon PL14 8NQ

Abstract

Background

Amisulpride is a potent substituted benzamide antipsychotic drug claimed to improve the negative symptoms of schizophrenia, particularly at low dosage.

Method

Sixty long-term in-patients with schizophrenia and selected for predominant negative symptoms were randomised to receive either haloperidol or amisulpride. Over a year there was systematic dose reduction, as symptoms allowed.

Results

There were no significant differences between the treatment groups in the proportion receiving low-dose treatment, the control of positive symptoms, or ratings of social behaviour, side-effects or tardive dyskinesia. For negative symptoms, there were consistent but non-significant trends in favour of amisulpride. The amisulpride patients required significantly less anticholinergic medication.

Conclusions

In chronically-hospitalised in-patients with schizophrenia characterised by persistent negative symptoms, amisulpride was a well-tolerated maintenance antipsychotic medication. The drug had only a limited effect in reducing negative symptoms, which were relatively stable, enduring phenomena in this sample, despite dosage reduction.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altman, D. G. (1991) Practical Statistics for Medical Research. London: Chapman and Hall.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington. DC: APA.Google Scholar
Andreasen, N. C. (1989) The Scale for the Assessment of Negative Symptoms (SANS): Conceptual and theoretical foundations. British Journal of Psychiatry, 155 (suppl. 7), 4952.Google Scholar
Åsberg, M., Montgomery, S. A., Perris, C., et al (1978) A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica, 57 (suppl. 271), 527.CrossRefGoogle Scholar
Barnes, T. R. E. (1989) A rating scale for drug-induced akathisia. British Journal of Psychiatry, 154, 672676.Google Scholar
Barnes, T. R. E. (1994) Issues in the clinical assessment of negative symptoms: Editorial review. Current Opinion in Psychiatry, 7, 3538.Google Scholar
Barnes, T. R. E. & Trauer, T. (1982) Reliability and validity of a tardive dyskinesia videotape rating technique. British Journal of Psychiatry, 140, 508515.CrossRefGoogle ScholarPubMed
Barnes, T. R. E. & McPhillips, M. A. (1996) Antipsychotic-induced extrapyramidal symptoms: Role of anticholinergic drugs in treatment. CNS Drugs, 6, 315330.CrossRefGoogle Scholar
Boyer, P., Lecrubier, Y., Puech, A. J., et al (1995) Treatment of negative symptoms in schizophrenia with amisulpride. British Journal of Psychiatry, 166, 6872.CrossRefGoogle ScholarPubMed
Carpenter, W. T., Conley, R. R., Buchanan, B. W., et al (1995) Patient response and resource management: another view of clozapine treatment of schizophrenia. American Journal of Psychiatry, 152, 827832.Google ScholarPubMed
Delcker, A., Schoon, M. L., Oczkowski, B., et al (1990) Amisulpride versus haloperidol in the treatment of schizophrenic patients – results of a double-blind study. Pharmacopsychiatry, 23, 125130.CrossRefGoogle ScholarPubMed
Hillert, A., Phillipp, M., Gattaz, W. E., et al (1994) Amisulpride vs. flupenthixol in the treatment of schizophrenia with predominant positive symptomatology: A controlled double-blind study. Neuropsychopharmacology, 10, 31S.Google Scholar
Kane, J. M., Rifkin, A., Woerner, M., et al (1983) Low-dose neuroleptic treatment of outpatient schizophrenics. Archives of General Psychiatry, 40, 893896.Google Scholar
Kane, J. M., Honigfeld, G., Singer, J., et al (1988) Clozapine for the treatment-resistant schizophrenic – a double-blind comparison with chlorpromazine. Archives of General Psychiatry, 45, 789796.Google Scholar
Krawiecka, M., Goldberg, D. & Vaughen, M. A. (1977) A standardised psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatrica Scandinavica, 55, 299308.Google Scholar
Loo, H., Polrier-Littre, M.-F., Theron, M., et al (1997) Amisulpride versus placebo in the medium-term treatment of the negative symptoms of schizophrenia. British Journal of Psychiatry, 170, 1822.Google Scholar
McPhillips, M. A. & Barnes, T. R. E. (1997) Negative symptoms. Current Opinion in Psychiatry, 10, 3035.CrossRefGoogle Scholar
Marder, S. R., Van Putten, T., Mintz, J., et al (1984) Costs and benefits of two doses of fluphenazine. Archives of General Psychiatry, 41, 10251029.CrossRefGoogle ScholarPubMed
Marder, S. R., Van Putten, T., Mintz, J., et al (1987) Low and conventional dose maintenance therapy with fluphenazine decanoate. Two-year outcome. Archives of General Psychiatry, 44, 518521.CrossRefGoogle ScholarPubMed
Möller, H.-J., Van Praag, H., Aufdembrinke, B., et al (1994) Negative symptoms in schizophrenia: considerations for clinical trials: Working group on negative symptoms in schizophrenia. Psychopharmacology, 115, 221228.CrossRefGoogle Scholar
Overall, J. E. & Gorham, D. (1982) The Brief Psychiatric Rating Scale. Psychological Reports, 10, 799812.CrossRefGoogle Scholar
Paillere-Martinot, M.-L., Lecrubier, Y., Martinot, J.-L., et al (1995) Improvement of some schizophrenic deficit symptoms with low doses of amisulpride. American Journal of Psychiatry, 152, 130133.Google ScholarPubMed
Puech, A. J., Lecrubier, Y. & Simon, P. (1984) Pharmacological classification of benzamides. Acta Psychiatrica Scandinavica, (suppl. 311). 139145.Google Scholar
Rey, M. J., Schulz, P., Costa, C., et al (1989) Guidelines for the dosage of neuroleptics. I: Chlorpromazine equivalents of orally administered neuroleptics. International Clinical Psychopharmacology, 4, 95104.CrossRefGoogle ScholarPubMed
Schooler, N. R. (1991) Maintenance medication for schizophrenia: strategies for dose reduction. Schizophrenia Bulletin, 17, 311324.CrossRefGoogle ScholarPubMed
Simpson, G. M. & Angus, J. W. S. (1970) A rating for extrapyramidal side-effects in drug-induced extrapyramidal disorders. Acta Psychiatrica Scandinavica, 212, 1119.Google Scholar
Wykes, T. & Sturt, E. (1986) The assessment of social behaviour in psychiatric patients: an assessment of the reliability and validity of the SBS schedule. British Journal of Psychiatry, 148, 111.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.