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Idazoxan and Response to Typical Neuroleptics in Treatment-Resistant Schizophrenia: Comparison with the Atypical Neuroleptic, Clozapine

  • Robert E. Litman (a1), Tung-Ping Su (a1), William Z. Potter (a1), Walter W. Hong (a1) and David Pickar (a1)...

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.

Copyright

Corresponding author

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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Idazoxan and Response to Typical Neuroleptics in Treatment-Resistant Schizophrenia: Comparison with the Atypical Neuroleptic, Clozapine

  • Robert E. Litman (a1), Tung-Ping Su (a1), William Z. Potter (a1), Walter W. Hong (a1) and David Pickar (a1)...

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Idazoxan and Response to Typical Neuroleptics in Treatment-Resistant Schizophrenia: Comparison with the Atypical Neuroleptic, Clozapine

  • Robert E. Litman (a1), Tung-Ping Su (a1), William Z. Potter (a1), Walter W. Hong (a1) and David Pickar (a1)...
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