Deficit Syndrome of Schizophrenia: Assuaging by Norepinephrine Reuptake Inhibitor
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 18, Issue 3
Abstract
Objective: Despite advances made in treating the positive symptoms of schizophrenia, treatment of negative symptoms remains an unmet therapeutic need. Reboxetine is a norepinephrine reuptake inhibitor (NRI). Objective of this study was to evaluate its effect on the negative symptoms of schizophrenia. Method: In a twelve-week randomized placebo-controlled trial, reboxetine was compared with placebo, as an add-on medication to haloperidol (5 mg), for treatment of 50 patients meeting diagnosis of schizophrenia. In this respect, Scale for Assessment of Negative Symptoms was used as the primary outcome measure. Treatment efficacy was analyzed by t test, Split-plot (Mixed) and repeated –measures analysis of variance (ANOVA). Result: The primary finding of this trial was a significant reduction in mean total scores of SANS in the reboxetine group, in comparison with the placebo group, at the end of the 12th week (P <0.0001). As well, in the experiment group, all of the sub-scales of SANS demonstrated considerable improvement. A trivial escalation in mean total scores of SAPS also was evident in the later group. Effect Size (ES) analysis too at the end of the trial, pointed to a large improvement with reboxetine. Conclusion: Reboxetine, as adjuvant to haloperidol, may cause a favorable outcome on behalf of improvement of deficit symptoms of schizophrenia.Schizophrenia is often described in terms of positive and negative (or deficit) symptoms [1]. Positive symptoms are those that most individuals do not normally experience but are present in people with schizophrenia. They can include delusions, disordered thoughts and speech, and tactile, auditory, visual, olfactory and gustatory hallucinations, typically regarded as manifestations of psychosis [2]. Positive symptoms generally respond well to medication [3]. Negative symptoms are deficits of normal emotional responses or of other thought processes and are less responsive to medication [3]. They commonly include flat expressions or little emotion, poverty of speech, pleasure, lack, and lack of motivation. Negative symptoms appear to contribute more to poor quality of life, functional ability, and the burden on others than do positive symptoms [2]. People with greater negative symptoms often have a history of poor adjustment before the onset of illness, and response to medication is often limited [3]. So, among the constellation of symptoms that characterize schizophrenia, negative symptoms have emerged as a critical feature linked to the functional impairment experienced by affected individuals [1]. Negative symptoms of schizophrenia represent deficiencies in emotional responsiveness, motivation, socialization, speech and movement. When persistent, they are held to account for much of the poor functional outcomes associated with schizophrenia. There are currently no approved pharmacological treatments. While the available evidence suggests that a combination of antipsychotic and antidepressant medication may be effective in treating negative symptoms, it is too limited to allow any firm conclusions [2]. Hence, the past decade has witnessed a resurgence of interest in the development of novel pharmacological agents to treat the negative symptoms of schizophrenia [3]. Antidepressants have plenty and varied credentials as plausible therapeutic agents regarding negative symptoms of schizophrenia [1-3]. Most of the trials of antidepressants in schizophrenia are add-on studies and placebocontrolled trials of antidepressants in non-depressed schizophrenic patients have not shown consistent results [4]. For example, whilst fluvoxamine and fluoxetine have shown efficacy over placebo in some trials [5,6] on the contrary, there are similar trials as well with citalopram and fluoxetine with negative outcome that make crucial judgment more complicated [7,8].
Authors and Affiliations
Saeed Shoja Shafti, Mohammad Sadeghe Jafarabad, Reza Azizi
Keywords
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- EP ID EP620652
- DOI 10.26717/BJSTR.2019.18.003162
- Views 181
- Downloads 0
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