Conclusion
Mental reintegration with a high level of work adjustment occurred with the sequential prolonged use of one or more of the antidepressant drugs in combination with chlorpromazine in a group of apathetic, withdrawn, regressed, male schizophrenic patients whose median duration of continuous hospitalization was 12.5 years. At the end of the treatment period of one year, six were in remission, four were much improved, five were improved, four were slightly improved, and one showed no improvement. No improvement occurred in the control groups. At the end of two years, 17 of the 20 patients on combined medication have been released from the hospital.
Controllable complications of hypotension, drug-induced parkinsonism, and akathisia occurred. Abrupt withdrawal of the antidepressant, with chlorpromazine maintained, failed to produce signs of drug dependency. EEG changes were minimal and limited to the chlorpromazine-trifluoperazine combination.
By this sequential, combined and prolonged method of treatment, unexpected clinical benefits have been achieved not usually found with severely regressed schizophrenic patients requiring prolonged hospitalization.
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References
Appel, K. E.; Myers, J. M., and Scheflen, A. E.: Prognosis in psychiatry; results of psychiatric treatment. Arch. Neurol. and Psychiat., 70:459, 1953.
Brill, H., and Patton, R. E.: Analysis of 1955–1956 population fall in New York State mental hospitals in first year of large-scale use of tranquilizing drugs. Am. J. Psychiat., 114:509, 1957.
Greenblatt, M.; York, R. H., and Brown, E. L.: From Custodial to Therapeutic Patient Care in Mental Hospitals; Explorations in Social Treatment. Russell Sage Foundation. New York. 1955.
A Guide to the Use of Stelazine in the Mental Hospital. Smith, Kline & French. Philadelphia. 1960.
Page, I. H.: Chemistry of the Brain. Science, 125: 721, 1957.
Van Meter, W. G.; Owens, H. F., and Himwich, H. E.: Effects of Tofranil, an antidepressant drug, on electrical potentials of rabbit brain. Canad. Psychiat. Assn. J., 4:S113, 1959.
Lorr, M.; McNair, D. M., Klett, C. J., and Lasky, J. J.: A confirmation of nine postulated psychotic syndromes (Inpatient Multidimensional Psychiatric Scale-IMPS), Am. Psychol., 15:495, 1960.
Lorr, M.; O'Connor, J. P., and Stafford, J. W.: The psychotic reaction profile. J. Clin. Psychol., 16:241–245, 1960.
Casey, J. F.; Hollister, L. E.; Klett, J. C.; Lasky, J. J., and Caffey, E. M. Jr.: Combined drug therapy of chronic schizophrenics. Am. J. Psychiat., 117:997, 1961.
Bennett, J. L., and Kooi, K. A.: Five phenothiazine derivatives-evaluation and toxicity studies. Arch. Gen. Psychiat., 4:413–418, 1961.
Bleuler, E.: Dementia Praecox or the Group of Schizophrenias. 1911. English translation by J. Zinkin. International Universities Press. New York. 1950.
Gildea, E. V.: Present status of the schizophrenia problem. Am. J. Med., 15:942, 1958.
Reinhart, R. R.; Schiff, S. F., and Sinnett, E. R.: The use of triflupromazine with iproniazid for the treatment of chronic schizophrenic patients. Am. J. Psychiat., 116:68–69, 1959.
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This paper, read at the annual meeting of the American Psychiatric Association, Chicago, May 1961, is from the Veterans Administration Hospital, and the University of Utah College of Medicine, Salt Lake City, Utah. The authors are grateful to Carroll A. Whitmer, Ph.D., chief of the psychology service, Veterans Administration Hospital, Salt Lake City, for assistance in rating, and to Madison Thomas, M.D., consultant in electro-encephalography.
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Bennett, J.L., Hamilton, L.D. Sequential use of antidepressant drugs with chlorpromazine in chronic schizophrenia. Psych Quar 37, 53–66 (1963). https://doi.org/10.1007/BF01566890
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DOI: https://doi.org/10.1007/BF01566890