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David Pickar, MD; Owen M. Wolkowitz, MD; Allen R. Doran, MD; Rodrigo Labarca, MD; Alec Roy, MB; Alan Breier, MD; Prem K. Narang, PhD

Arch Gen Psychiatry. 1987;44(2):113-118.

Abstract
• We administered verapamil hydrochloride, a calcium channel antagonist, to seven chronically ill schizophrenic patients for five weeks under double-blind, placebo-controlled conditions. No therapeutic effect was noted. Worsening in hostile and uncooperative behaviors and a syndrome of heightened emotional tone was observed during verapamil treatment and during the postverapamil placebo period. Verapamil produced significant increases in cerebrospinal fluid (CSF) and plasma levels of homovanillic acid and in plasma levels of prolactin, as well as significant decreases in plasma levels of 3-methoxy-4-hydroxyphenethyleneglycol. Verapamil and its active metabolite, norverapamil, were partitioned into CSF with CSF/plasma ratios of 0.06 and 0.04, respectively. The lack of therapeutic effects of verapamil in schizophrenic patients differs from earlier reports of its usefulness in treating manic patients. The biochemical and clinical data from our study suggest the possibility that verapamil exerts behaviorally relevant central nervous system activity in schizophrenic patients.

Author Affiliations
From the Section on Clinical Studies, Clinical Neuroscience Branch, National Institute of Mental Health (Drs Pickar, Wolkowitz, Doran, Labarca, Roy, and Breier); and Clinical Pharmacokinetics Research Laboratory, Pharmacy Department, National Institutes of Health, (Dr Narang), Bethesda, Md. Dr Wolkowitz is now with the Department of Psychiatry, University of California—San Francisco; Dr Doran, University of California—Davis, Sacramento; Dr Labarca, Catholic University Medical School, Santiago, Chile; and Dr Roy, Laboratory of Clinical Studies, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Md.

Footnotes
Accepted for publication Sept 24, 1986.

Reprint requests to Section on Clinical Studies, Clinical Neuroscience Branch, National Institute of Mental Health, Bldg 10, Room 4N214, 9000 Rockville Pike, Bethesda, MD 20892 (Dr Pickar).

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