Shamabadi Ahmad, Rafiei-Tabatabaei Elham-Sadat, Kazemzadeh Kimia, Farahmand Kimia, Fallahpour Bita, Khodaei Ardakani Mohammad-Reza, Akhondzadeh Shahin
Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Psychiatry, Razi Hospital, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Int J Neuropsychopharmacol. 2024 Dec 28;28(1). doi: 10.1093/ijnp/pyae051.
Negative symptoms of schizophrenia represent an unmet therapeutic need for many patients in whom pentoxifylline may be effective in terms of its dopaminergic, anti-inflammatory, and cerebral blood flow-increasing properties. This study aimed to evaluate pentoxifylline as a therapeutic agent for improving negative symptoms of schizophrenia.
Chronic schizophrenia outpatients experiencing significant negative symptoms were randomly allocated to receive pentoxifylline 400 mg or matched placebo every 12 hours for 8 weeks. All patients were clinically stable as they had received risperidone for at least 2 months, which was continued. The participants were assessed using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale, Extrapyramidal Symptom Rating Scale, and side effect checklist.
The patients' baseline characteristics were comparable between the groups. There was a significant time-treatment interaction effect on PANSS negative subscale scores (ηP2=0.075), with the pentoxifylline group showing significantly greater reductions until weeks 4 (Cohen d = 0.512) and 8 (Cohen d = 0.622). Also, this group showed a significantly better response by week 8. Other PANSS scores, Hamilton Depression Rating Scale scores, Extrapyramidal Symptom Rating Scale scores, and side effect frequencies were comparable between the groups. Pentoxifylline showed a nonsignificant higher remission of 37.1% compared with 14.7% in the placebo group.
Pentoxifylline was safely and tolerably beneficial for the primary negative symptoms of chronic schizophrenia.
精神分裂症的阴性症状对许多患者而言是尚未满足的治疗需求，己酮可可碱因其多巴胺能、抗炎及增加脑血流量的特性可能对这些患者有效。本研究旨在评估己酮可可碱作为改善精神分裂症阴性症状的治疗药物的效果。
将存在明显阴性症状的慢性精神分裂症门诊患者随机分配，每12小时接受400mg己酮可可碱或匹配的安慰剂治疗，为期8周。所有患者临床状况稳定，因为他们至少接受了2个月的利培酮治疗，且该治疗持续进行。使用阳性和阴性症状量表（PANSS）、汉密尔顿抑郁评定量表、锥体外系症状评定量表及副作用清单对参与者进行评估。
两组患者的基线特征具有可比性。在PANSS阴性分量表得分上存在显著的时间-治疗交互效应（ηP2=0.075），己酮可可碱组在第4周（Cohen d = 0.512）和第8周（Cohen d = 0.622）时显示出显著更大程度的降低。此外，该组在第8周时显示出明显更好的反应。两组之间的其他PANSS得分、汉密尔顿抑郁评定量表得分、锥体外系症状评定量表得分及副作用发生频率具有可比性。己酮可可碱组的缓解率为37.1%，高于安慰剂组的14.7%，但差异无统计学意义。
己酮可可碱对慢性精神分裂症的原发性阴性症状具有安全且耐受性良好的益处。
