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A placebo-controlled trial of fluoxetine added to neuroleptic in patients with schizophrenia

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Abstract

Following a 2-week placebo lead-in, schizophrenic patients were randomly assigned to fluoxetine 20 mg/day or placebo added to depot neuroleptic for a 6-week, double blind trial. All patients had received a stable dose of depot neuroleptic for at least 6 months and did not meet criteria for depression. Serum samples were obtained at baseline and at weeks 4 and 6. Scores on the negative symptom subscale of the Brief Psychiatric Rating Scale (BPRS) were significantly lower at week 6, controlling for baseline scores, in patients receiving fluoxetine (n=20) compared to patients receiving placebo (n=21). Measures of psychosis, depression, global functioning and extrapyramidal symptoms (EPS) did not differ between groups at week 6. Fluoxetine administration was associated with a mean 65% increase in serum fluphenazine concentrations in 15 patients and a mean 20% increase in serum haloperidol concentrations in three patients. The change in negative symptoms at week 6 did not correlate with serum concentrations of fluoxetine or norfluoxetine, but did inversely correlate withS-norfluoxetine, an active stereoisomer of fluoxetine. For these chronically ill patients, fluoxetine significantly improved negative symptoms and did not worsen EPS, despite causing substantial elevation in serum concentrations of neuroleptics.

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Authors and Affiliations

  1. Freedom Trail Clinic, 25 Staniford St., 02114, Boston, MA, USA

    D. C. Goff & E. Amico

  2. Psychiatry Service, Massachusetts General Hospital, Boston, MA, USA

    D. C. Goff

  3. Boston Veterans Affairs Outpatient Clinic, Boston, MA, USA

    O. Sarid-Segal

  4. College of Pharmacy and Medicine, University of Saskatchewan, Saskatoon, Sask., Canada

    K. K. Midha & J. W. Hubbard

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  1. D. C. Goff
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  2. E. Amico
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  3. O. Sarid-Segal
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  4. K. K. Midha
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  5. J. W. Hubbard
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Goff, D.C., Amico, E., Sarid-Segal, O. et al. A placebo-controlled trial of fluoxetine added to neuroleptic in patients with schizophrenia. Psychopharmacology 117, 417–423 (1995). https://doi.org/10.1007/BF02246213

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  • DOI: https://doi.org/10.1007/BF02246213

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