scholarly journals Comparison of therapeutic effects of monotherapy of chlorpromazine, risperidone and their combination in newly diagnosed schizophrenic patients

2018 ◽  
Vol 7 (7) ◽  
pp. 1273
Author(s):  
Tarun Vijaywargia
Keyword(s):  
Negative Symptoms ◽  
Positive Symptom ◽  
Therapeutic Effects ◽  
Positive Symptoms ◽  
Newly Diagnosed ◽  
Anti Psychotic ◽  
Double Blind ◽  
Oral Risperidone ◽  
Beneficial Effects ◽  
Schizophrenic Patients

Background: This study evaluates and compares how negative and positive symptoms of schizophrenia were influenced with monotherapy with a first-generation anti-psychotic medication (Chlorpromazine) and a second generation anti-psychotic medication (Risperidone) and by their combination, both of which are commonly used in clinical psychiatric practice.Methods: It was randomized, double-blind, controlled clinical study performed in Indian newly diagnosed schizophrenic patients in the Department of psychiatry from Feb 2003 to March 2004. Patients 18 (eighteen) patients aged 20 to 60 years diagnosed schizophrenics according to ICD-10 Criteria who visited in outpatient department of psychiatry during study period. Three groups of 6 Patient each, group-1 - was treated with oral Chlorpromazine 100 mg 12 hly, group -2 - was treated with oral Risperidone 2mg 12 hly group 3 -was treated with combination of oral Chlorpromazine 100mg 12 hly + oral Risperidone 2 mg 12 hly. How symptomatology in schizophrenic patients affected, is measured by applying various validated psychiatric scales like Brief psychiatric Rating Score (BPRS), Scale for assessment of positive symptom(SAPS), and Scale for Assessment of Negative Symptoms (SANS).Results: the study showed that the combination therapy of oral Chlorpromazine 100 mg 12 hly + Risperidone 2mg 12 hly had reduced the overall beneficial effects which were achieved with monotherapy of both the drugs.Conclusions: In this study, the therapeutic effects of combination of oral Chlorpromazine 100 mg 12 hly + Risperidone 2 mg 12 hly found to be reduced on positive symptoms and negative symptoms of schizophrenia, assessed on SAPS and SANS scoring scales when compared with beneficial effects which were achieved with monotherapy of both the drugs.

scholarly journals Adjuvant role of testosterone in treatment of schizophrenia and its interaction with combination of first and second generation anti-psychotics, chlorpromazine and risperidone

2018 ◽  
Vol 7 (7) ◽  
pp. 1247
Author(s):  
Tarun Vijaywargia
Keyword(s):  
Single Dose ◽  
Negative Symptoms ◽  
Second Generation ◽  
Positive Symptom ◽  
Anti Psychotic ◽  
Double Blind ◽  
Oral Risperidone ◽  
Schizophrenic Patients ◽  
First And Second Generation

Background: There is great controversy about role of male sex steroid, testosterone, in mental disorders like schizophrenia. This study assessed the effectiveness of testosterone in schizophrenic patients and probes how it modulates the action of combination of first and second generation anti-psychotic medications (Chlorpromazine + Risperidone) both of which are very commonly used anti-psychotic agents in clinical psychiatric practice.Methods: It Is randomized, double-blind, Clinical study performed in Indian schizophrenic patients (new cases) in the Department of psychiatry from Feb 2003 to March 2004. Patients twelve (12) patients aged 20 to 60 years diagnosed schizophrenics according to ICD-10 Criteria who visited in outpatient department of psychiatry during study period. 12 Patient was treated with combination of oral Chlorpromazine 200mg BD + oral Risperidone 2mg BD, half of the 12 patients also received single dose of testosterone 100mg intramuscularly with above-mentioned treatment. Measure How symptomatology in schizophrenic patients affected is measured by applying various validated psychiatric scales like Brief psychiatric Rating Score (BPRS), Scale for assessment of positive symptom(SAPS), and Scale for Assessment of Negative Symptoms (SANS).Results: Single dose of Testosterone 100mg administered initially by I.M. route potentiated the reduction level in negative symptoms of schizophrenia by 119% in patients receiving oral Chlorpromazine 200mg along with oral Risperidone 4mg/day.Conclusions: In this study, Testosterone potentiated the effects of combination of oral Chlorpromazine 100mg BD + Risperidone 2mg BD, on general psychotic manifestations, positive symptoms and negative symptoms of schizophrenia, assessed on BPRS, SAPS and SANS scoring scales, however the effect is most pronounced in negative symptomology of schizophrenia.

Negative Symptoms at Discharge and Outcome in Schizophrenia

1995 ◽  
Vol 166 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Hai-Gwo Hwu ◽  
Happy Tan ◽  
Chu-Chang Chen ◽  
Ling-Ling Yeh
Keyword(s):  
Clinical Outcome ◽  
Social Functioning ◽  
Symptom Score ◽  
Negative Symptoms ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Symptom Scores ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

BackgroundThe clinical significance in schizophrenia of positive and negative symptoms at discharge was assessed.MethodOf schizophrenic patients fulfilling DSM–III criteria, 113 were recruited for this study. Personal, social and psychopathological data were collected and all cases were followed up at one and two years after discharge.ResultsThe presence of positive symptoms (64 cases), without concomitant negative symptoms, did not predict the follow-up social function and positive symptom score. Conversely, the presence of negative symptoms (31 cases) predicted worse social functioning (P < 0.05 to P < 0.005) and higher positive symptom scores (P < 0.01) at follow-up using MANOVA. Eighteen cases (15.9%) had neither positive nor negative symptoms and had the best clinical outcome.ConclusionsNegative, but not positive, symptoms assessed at discharge are an important predictor of poor outcome. In addition, negative symptoms may themselves expose a biological vulnerability to the presence of positive symptoms.

Positive and Negative Symptoms in Psychiatry

1986 ◽  
Vol 148 (5) ◽  
pp. 587-589 ◽  
Author(s):  
Michael R. Trimble
Keyword(s):  
Negative Symptoms ◽  
Geographical Location ◽  
Personal Communication ◽  
Thought Disorder ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Market Research Company ◽  
Research Company ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

The terms positive and negative symptoms have slipped into the language of contemporary psychiatry with comparative ease. It is not uncommon for these expressions to be used with little explanation, both at meeting and in written communications, with the implicit understanding that their meaning is understood and that somehow they are of value to our knowledge of psychopathology. However, that there are no clear guide-lines at present for our use of these terms is shown from a recent survey of psychiatrists' opinions from a market research company (Martin Hamblin Research-Personal Communication). As part of a series of questions asked to many psychiatrists of differing age, geographical location, and status, they were asked about the meaning of these terms, positive and negative symptoms and the proportion of schizophrenic patients having them. Of the categories quoted by Crow (1980–81) as positive symptoms, 68% considered that delusions were positive symptoms, 63% hallucinations, and only 35% thought disorder. In contrast, 18% thought that behaviour disturbance was a positive symptom, a similar figure (15%) being given for passivity feelings. Considerable variation was noted, however, with hallucinations being considered positive by only 33% of London psychiatrists, thought disorder by only 11% of those qualified 16–25 years, and one-quarter of all registrars and psychiatrists from Midland Health Districts considered passivity feelings to fall into this category. Even greater disagreement was recorded for negative symptoms. Thus, the symptom most often associated with this category was apathy, by 52% of respondents. Only 26% considered that withdrawal was a negative symptom, the percentage data for lack of motivation and blunting of affect being 37% and 15% respectively.

Clozapine in treatment-resistant schizophrenic patients: preliminary results from an open prospective study

1996 ◽  
Vol 13 (1) ◽  
pp. 13-18
Author(s):  
Isabelle Jalenques ◽  
Eliane Albuisson ◽  
Igor Tauveron
Keyword(s):  
Prospective Study ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Health Care Utilisation ◽  
Positive Symptoms ◽  
Treatment Resistant ◽  
Beneficial Effects ◽  
Clozapine Treatment ◽  
Schizophrenic Patients ◽  
Open Prospective Study

AbstractObjective:This report describes an open prospective study of the effects of clozapine on positive and negative symptomatology in treatment resistant schizophrenic patients.Method:In this prospective study, 15 DSM-III-R schizophrenic patients, who had failed to respond to various neuroleptics were followed up for a period of 21 months (median: 9; 25th and 75th percentiles: 4-10). When clozapine treatment was initiated, the mean duration of the illness was 16 +/-9 years. Brief Psychiatric Rating Scale (BPRS) scores, BPRS ‘positive symptoms’ and BPRS ‘anergia factor’ scores were all rated at days 0 and 15, months one, two and three and every three months thereafter.Results:Significant improvements in total BPRS scores, BPRS positive symptoms and anergia factor were recorded and resulted in two distinct patterns of outcome. The improvements in BPRS scores translated into marked changes in health care utilisation and in sheltered employment. Of the side effects noted, dry mouth was more common in the first month after wash-out (three patients), while hypersalivation was more frequent after this period (eight patients). There was no agranulocytosis in this cohort. Two cases of eosinophilla occurred during the first month. Weight gain affected six patients.Conclusions:We found that clozapine offers particular benefits for some treatment-resistant schizophrenic patients despite the increased hematologic risk. Our study also indicates that the beneficial effects of clozapine are delayed in relation to negative symptoms as compared with positive symptoms.

Duration of illness and structure of symptoms in schizophrenia

1999 ◽  
Vol 29 (4) ◽  
pp. 915-924 ◽  
Author(s):  
RAMIN MOJTABAI
Keyword(s):  
Negative Symptoms ◽  
Average Duration ◽  
Meta Analysis ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Cross Sectional ◽  
Pair Correlations ◽  
Duration Of Illness ◽  
Schizophrenic Patients ◽  
Sectional Structure

Background. Previous research has mainly focused on the cross-sectional structure of symptoms in schizophrenia. This meta-analysis examined the association of duration of illness with the structure of symptoms.Methods. Using explicit criteria, 22 studies reporting on the correlations of symptoms in 2665 schizophrenic patients were selected. From each study, symptom-pair correlations for negative symptoms as rated by Scale for the Assessment of Negative Symptoms (SANS) and positive symptoms as rated by the Scale for the Assessment of Positive Symptoms (SAPS) were extracted. Variability among symptom-pair correlations across studies was assessed using tests of homogeneity. For symptom-pair correlations which were not found to be homogeneous, the association of average duration of illness with the symptom-pair correlations were examined.Results. There was considerable variability in symptom-pair correlations across studies. Part of this variability was explainable by variations in average duration of illness. Longer duration of illness was associated with lower negative–negative symptom-pair correlations and higher negative–positive symptom-pair correlations.Conclusions. The findings suggest that the structure of symptoms in schizophrenia evolves over time, following a consistent pattern. In the early stages of illness, negative and positive symptoms form cohesive dimensions. With time, these dimensions become less cohesive and the boundaries between them, less clear.

scholarly journals A Comparative Study between Olanzapine and Risperidone in the Management of Schizophrenia

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Saeed Shoja Shafti ◽  
Mahsa Gilanipoor
Keyword(s):  
Negative Symptoms ◽  
Primary Outcome ◽  
Positive Symptoms ◽  
Random Allocation ◽  
Severity Scale ◽  
Double Blind ◽  
Safety And Efficacy ◽  
Superior Efficacy ◽  
Schizophrenic Patients ◽  
Risperidone Group

Introduction. Since a variety of comparisons between risperidone and olanzapine have resulted in diverse outcomes, so safety and efficacy of them were compared again in a new trial.Method. Sixty female schizophrenic patients entered into one of the assigned groups for random allocation to olanzapine or risperidone (n=30in each group) in a double-blind, 12-week clinical trial. Scale for Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS) were used as the primary outcome measures. Clinical Global Impressions-Severity Scale (CGI-S), Schedule for Assessment of Insight (SAI), and finally Simpson Angus Scale (SAS) as well were employed as secondary scales.Results. While both of olanzapine and risperidone were significantly effective for improvement of positive symptoms (P<0.0001), as regards negative symptoms, it was so only by means of olanzapine (P<0.0003). CGI-S and SAI, as well, were significantly improved in both of the groups. SAS increment was significant only in the risperidone group (P<0.02).Conclusion. While both of olanzapine and risperidone were equally effective for improvement of positive symptoms and insight, olanzapine showed superior efficacy with respect to negative symptoms, along with lesser extrapyramidal side effects, in comparison with risperidone.

Stability of positive and negative symptoms in schizophrenic patients: a 3-year follow-up study

1995 ◽  
Vol 10 (5) ◽  
pp. 228-236 ◽  
Author(s):  
S Dollfus ◽  
M Petit
Keyword(s):  
Negative Symptoms ◽  
Strong Stability ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Acute Group ◽  
Thought Disorders ◽  
Number Of Patients ◽  
Schizophrenic Patients ◽  
The Mean ◽  
Over Time

SummaryThe course of negative and positive symptoms was studied in neuroleptic-treated patients over a 3-year period, in consideration also of the initial phase of illness (post-acute or chronic). This study was carried out in a broadly defined schizophrenic sample, in order not to give preference to one diagnostic subgroup over another. Forty-six patients were evaluated every year for 3 years, 23 in the post-acute group and 23 in the chronic group. Aggravations of the Clinical Global Impression (CGI) and of the SANS total score were observed, regardless of the group (chronic or post-acute). This global aggravation confirmed Kraepelin's concept of dementia praecox; moreover, this aggravation was not due to an increase in the number of patients relapsing, or to an aggravation of akinesia. Three types of negative and positive symptom courses were observed: i) the mean sub-scores of positive symptoms, such as hallucinations, delusions, positive formal thought disorders, and of negative symptoms such as flattening affect, avolition/apathy and attentional impairment, did not vary significantly over time in either group; ii) the mean sub-scores of bizarre behavior and alogia fluctuated over time (p < 0.05) and only poverty of speech was perfectly stable among the items constituting alogia; iii) the mean subscores of anhedonia/asociality worsened significantly over time irrespective of the groups (p < 0.05), and among the items constituting anhedonia, recreational interest-activities and intimacy-closeness abilities worsened (p < 0.05 and p < 0.01, respectively). This aggravation was neither due to an increase in neuroleptic doses nor to the duration and chronicity of illness. However, negative symptoms, except anhedonia, can be reversible in some patients. The very strong stability of anhedonia, whatever the group, emphasize the importance of taking anhedonia into account in future diagnostic classifications.

Systematic review and exploratory meta-analysis of the efficacy, safety, and biological effects of psychostimulants and atomoxetine in patients with schizophrenia or schizoaffective disorder

CNS Spectrums ◽  
2018 ◽  
Vol 24 (5) ◽  
pp. 479-495 ◽  
Author(s):  
Marco Solmi ◽  
Michele Fornaro ◽  
Kuniyoshi Toyoshima ◽  
Andrè F. Carvalho ◽  
Cristiano A. Köhler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Problem Solving ◽  
Executive Functions ◽  
Negative Symptoms ◽  
Biological Effects ◽  
Meta Analysis ◽  
Cortical Activation ◽  
Therapeutic Effects ◽  
Double Blind ◽  
Relapse Prediction

ObjectiveOur aim was to summarize the efficacy and safety of atomoxetine, amphetamines, and methylphenidate in schizophrenia.MethodsWe undertook a systematic review, searching PubMed/Scopus/Clinicaltrials.gov for double-blind, randomized, placebo-controlled studies of psychostimulants or atomoxetine in schizophrenia published up to 1 January 2017. A meta-analysis of outcomes reported in two or more studies is presented.ResultsWe included 22 studies investigating therapeutic effects of stimulants (k=14) or measuring symptomatic worsening/relapse prediction after stimulant challenge (k=6). Six studies of these two groups plus one additional study investigated biological effects of psychostimulants or atomoxetine. No effect resulted from interventional studies on weight loss (k=1), smoking cessation (k=1), and positive symptoms (k=12), and no improvement was reported with atomoxetine (k=3) for negative symptoms, with equivocal findings for negative (k=6) and mood symptoms (k=2) with amphetamines. Attention, processing speed, working memory, problem solving, and executive functions, among others, showed from no to some improvement with atomoxetine (k=3) or amphetamines (k=6). Meta-analysis did not confirm any effect of stimulants in any symptom domain, including negative symptoms, apart from atomoxetine improving problem solving (k=2, standardized mean difference (SMD)=0.73, 95% CI=0.10–1.36,p=0.02, I2=0%), and trending toward significant improvement in executive functions with amphetamines (k=2, SMD=0.80, 95% CI=−1.68 to +0.08,p=0.08, I2=66%). In challenge studies, amphetamines (k=1) did not worsen symptoms, and methylphenidate (k=5) consistently worsened or predicted relapse. Biological effects of atomoxetine (k=1) and amphetamines (k=1) were cortical activation, without change in β-endorphin (k=1), improved response to antipsychotics after amphetamine challenge (k=2), and an increase of growth hormone–mediated psychosis with methylphenidate (k=2). No major side effects were reported (k=6).ConclusionsNo efficacy for stimulants or atomoxetine on negative symptoms is proven. Atomoxetine or amphetamines may improve cognitive symptoms, while methylphenidate should be avoided in patients with schizophrenia. Insufficient evidence is available to draw firm conclusions.

Cognitive Function in Schizophrenia: Association with Negative and Positive Symptoms

1996 ◽  
Vol 78 (1) ◽  
pp. 123-128 ◽  
Author(s):  
Ronald A. Capleton
Keyword(s):  
Cognitive Functioning ◽  
Negative Symptoms ◽  
Wisconsin Card Sort Test ◽  
Positive Symptoms ◽  
Word Fluency ◽  
Generation Task ◽  
Card Sort ◽  
Word Generation ◽  
Perseverative Errors ◽  
Schizophrenic Patients

20 schizophrenic patients were classified as having either predominantly negative ( n = 11) or predominantly positive symptoms ( n = 9), utilizing the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms. Cognitive functioning was evaluated in these participants and 10 non-patient controls using a word-fluency test and word-generation task. Finally, all participants were evaluated using the Coglab Card Sort Test, a computerized version of the Wisconsin Card Sort Test. The only reliable difference in performance among groups was on perseverative errors on the Coglab Card Sort Test Schizophrenic participants made significantly more perseverative errors than controls and those classified as having primarily negative symptoms made more perseverative errors than those classified as having predominantly positive symptoms. These findings confirm previous reports with respect to cognitive functioning of schizophrenic patients and are consistent with the hypotheses regarding frontal lobe dysfunction in schizophrenia. These data encourage research with larger samples.

New dopaminergic and non-dopaminergic theories in schizophrenia and their therapeutic impact

1997 ◽  
Vol 9 (2) ◽  
pp. 64-67
Author(s):  
R.S. Kahn
Keyword(s):  
Cognitive Deficits ◽  
Negative Symptoms ◽  
Dopamine Neurons ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
The Core ◽  
Schizophrenic Patients ◽  
Core Symptoms ◽  
Influential Theory

The dopamine (DA) hypothesis of schizophrenia, postulating that schizophrenia is characterized by increased dopamine function, has been the most influential theory on the pathogenesis of schizophrenia. It has recently been revised based on the appreciation that the core symptoms of schizophrenia may not be the positive (psychotic) symptoms, but rather the negative symptoms and the cognitive deficits found in schizophrenic patients. This revision has prompted the hypothesis that schizophrenia is characterized by both decreased prefrontal dopamine activity (causing deficit symptoms) and increased dopamine activity in mesolimbic dopamine neurons (causing positive symptoms).Notwithstanding this revision of a role for dopamine in schizophrenia, it has become increasingly evident that dysfunction of other monoaminergic systems may be as important in contributing to the pathophysiology of schizophrenia. Specifically, the putative role of serotonin (5-hydroxytryptamine, 5-HT) in schizophrenia is gaining considerable attention. Several observations, such as the ability of the 5-HT antagonist, ritanserin, to alleviate schizophrenic symptoms and, when added to haloperidol (Haldol®), to decrease its extrapyramidal side-effects (EPS), have stimulated studies into a role of 5-HT in schizophrenia. The finding that clozapine (Leponex®), clinically superior to conventional neuroleptics, is a weak DA2 antagonist but a potent 5-HT1c and 5-HT2 antagonist has further stimulated 5-HT-related research in schizophrenia.

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