Alprazolam augmentation of the antipsychotic effects of fluphenazine in schizophrenic patients. Preliminary results
O. M. Wolkowitz, A. Breier, A. Doran, J. Kelsoe, P. Lucas, S. M. Paul and D. Pickar
Section on Clinical Studies, National Institute of Mental Health, Bethesda, Md. 20892.
Alprazolam was added, under double-blind conditions, to stable fluphenazine
hydrochloride regimens in 12 symptomatic, chronically ill inpatients with
schizophrenia. The addition of alprazolam was associated with significant,
albeit modest, reductions in global psychosis, thought disorder, and
paranoia ratings, with a return to pretreatment levels on discontinuation
of alprazolam treatment. Improvement in "negative symptoms" such as
emotional withdrawal paralleled the changes in "positive symptoms" but did
not, in itself, reach statistical significance. There were no significant
changes in group mean plasma levels of homovanillic acid or
3-methoxy-4-hydroxyphenylglycol during alprazolam treatment, although group
mean serum cortisol levels were significantly decreased by alprazolam
treatment. Patients who responded favorably to alprazolam treatment were
significantly more psychotic or anxious before treatment, were older,
showed significant alprazolam-associated reductions in plasma levels of
homovanillic acid, and had significantly more prominent prefrontal cortex
atrophy on computed tomographic scans than patients in whom alprazolam was
without therapeutic effect. These preliminary data, based on a small
sample, suggest that some patients with schizophrenia who are only
partially responsive to standard neuroleptic treatment may benefit from the
addition of triazolobenzodiazepines, such as alprazolam.
