Amiri Afshar, Noorbala Ahmad-Ali, Nejatisafa Ali-Akbar, Ghoreishi Abolfazl, Derakhshan Mohammad-Kamran, Khodaie-Ardakani Mohammad-Reza, Hajiazim Mohammad, Raznahan Maedeh, Akhondzadeh Shahin
Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Hum Psychopharmacol. 2008 Mar;23(2):79-86. doi: 10.1002/hup.902.
It has been reported that selegiline, a Selective Monoamine Oxidase Inhibitor B (MAOI-B), at low doses would be helpful for treating negative symptoms in schizophrenia. Nevertheless, the results are contradictory so far. This study was designed to investigate the effect of selegiline added to risperidone as augmentation therapy in patients with chronic schizophrenia and prominent negative symptoms in an 8 week, double blind and randomized clinical trial.
Eligible participants in this study were 40 patients with chronic schizophrenia. All patients were inpatients and were in the active phase of the illness, and met DSM-IV-TR criteria for schizophrenia. Patients were allocated in a random fashion, 20 to risperidone 6 mg/day plus selegiline 10 mg/day (5 mg bid) and 20 to risperidone 6 mg/day plus placebo. The principal measure of the outcome was Positive and Negative Syndrome Scale (PANSS).
Although both protocols significantly decreased the score of the positive, negative, and general psychopathological symptoms over the trial period, the combination of risperidone and selegiline showed a significant superiority over risperidone alone in decreasing negative symptoms and PANSS total scores.
The present study indicates selegiline as a potential adjunctive treatment strategy for the negative symptoms of schizophrenia. Nevertheless, results of larger controlled trials are needed before recommendation for a broad clinical application can be made.
据报道,作为一种选择性单胺氧化酶抑制剂B(MAOI - B),低剂量司来吉兰有助于治疗精神分裂症的阴性症状。然而,目前结果相互矛盾。本研究旨在通过一项为期8周的双盲随机临床试验,调查在利培酮基础上加用司来吉兰作为增效治疗对慢性精神分裂症且存在明显阴性症状患者的影响。
本研究的合格参与者为40例慢性精神分裂症患者。所有患者均为住院患者且处于疾病活动期,符合精神分裂症的DSM - IV - TR标准。患者被随机分配,其中20例接受利培酮6毫克/天加司来吉兰10毫克/天(5毫克,每日两次)治疗,另外20例接受利培酮6毫克/天加安慰剂治疗。主要结局指标为阳性和阴性症状量表(PANSS)。
尽管两种方案在试验期间均显著降低了阳性、阴性及一般精神病理症状的评分,但利培酮与司来吉兰联合使用在减轻阴性症状和PANSS总分方面比单独使用利培酮显示出显著优势。
本研究表明司来吉兰可作为治疗精神分裂症阴性症状的一种潜在辅助治疗策略。然而,在推荐广泛临床应用之前,还需要更大规模对照试验的结果。