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A Double-blind, Placebo-Controlled Trial of Amitriptyline Added to Perphenazine

Brigitte A. Prusoff, PhD; Donald H. Williams, MD; Myrna M. Weissman, PhD; Boris M. Astrachan, MD

Arch Gen Psychiatry. 1979;36(5):569-575.

Abstract
• The combination of antidepressants and neuroleptics has been widely recommended and commonly used clinically for the schizophrenic patient who becomes depressed. However, the value of the combination for these patients has not been clearly demonstrated. This report presents results of a double-blind, randomized, placebo-controlled clinical trial designed to evaluate the combination of perphenazine and amitriptyline hydrochloride with that of perphenazine alone in the treatment of 35 ambulatory chronic schizophrenic patients in whom depressive symptoms developed. Results showed that the addition of amitriptyline to perphenazine, when compared with perphenazine alone, was more effective in reducing symptoms of depression after four months of treatment, but less effective in reducing thought disorder. The study concludes that the value of adding an antidepressant to the usual neuroleptic in the treatment of secondary depression in schizophrenia should be reviewed.

Author Affiliations
From the Department of Psychiatry and the Connecticut Mental Health Center, Yale University School of Medicine, New Haven.

Footnotes
Accepted for publication Sept 20, 1978.

Reprint requests to Department of Psychiatry, Depression Research Unit, Yale University School of Medicine, 904 Howard Ave, Suite 2A, New Haven, CT 06519 (Dr Prusoff).

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