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Alprazolam Augmentation of the Antipsychotic Effects of Fluphenazine in Schizophrenic PatientsPreliminary Results
Owen M. Wolkowitz, MD;
Alan Breier, MD;
Allen Doran, MD;
John Kelsoe, MD;
Peter Lucas, MD;
Steven M. Paul, MD;
David Pickar, MD
Arch Gen Psychiatry. 1988;45(7):664-671.
Abstract
• 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.
Author Affiliations
From the Section on Clinical Studies, Clinical Neuroscience Branch, National Institute of Mental Health, Bethesda, Md. Dr Wolkowitz is now with the Department of Psychiatry, University of California, San Francisco; Dr Breier is now with the Maryland Psychiatric Research Center, University of Maryland, Baltimore; Dr Doran is now with the Department of Psychiatry, University of California, Davis; and Dr Lucas is now with the Department of Psychiatry, Veterans Administration Hospital, Sepulveda, Calif.
Footnotes
Accepted for publication Jan 18, 1988.
Reprint requests to Section on Clinical Studies, Clinical Neuroscience Branch, NIH Bldg 10, Room 4N212, 9000 Rockville Pike, Bethesda, MD 20892 (Dr Pickar).
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