Reboxetine, as an adjuvant to haloperidol, may have a helpful effect on the deficit syndrome of schizophrenia.
Tackling negative symptoms in male patients with schizophrenia using a norepinephrine reuptake inhibitor Objective: Placebo-controlled trials of antidepressants in patients with schizophrenia with prominent negative symptoms usually have presented contradictory results. Reboxetine is a norepinephrine reuptake inhibitor (NRI) antidepressant. Preceding studies regarding possible advantageous effects of reboxetine on deficit symptoms of schizophrenia, too, have resulted in inconsistent outcomes. The present study again assesses the effectiveness of reboxetine as an adjunctive treatment in a group of patients with schizophrenia with prominent negative symptoms. Method: Fifty male inpatients meeting the diagnosis of schizophrenia were enrolled into a 12-week parallel group, double-blind study with random assignment to reboxetine (n=25 patients) or placebo (n=25 patients). Inclusion criterion, in addition to the diagnosis of schizophrenia, was the existence of obvious negative symptoms for a duration of at least two years. Cases with existing co-morbidities like major depressive disorder or diagnosis of schizoaffective disorder or cases that were prescribed long-acting depot or atypical antipsychotics, antidepressants, or lithium were excluded. The Scale for Assessment of Negative Symptoms (SANS) was used as the primary outcome measure. Scale for Assessment of Positive Symptoms (SAPS), Simpson Angus Scale (SAS), Hamilton Rating Scale for Depression (HAM-D) and Mini-Mental Status Examination (MMSE) were used for comparison of the intervening parameters in this study. Duration of the assessment was twelve weeks, and the patients were assessed at baseline (week 0), and at the end of the 4 th , 8 th , and 12 th week by SANS and SAPS. Treatment efficacy was analyzed by t test and repeated-measures analysis of variance (ANOVA). Statistical significance was defined as a 2-sided p value ≤0.05. Results: According to our findings, 76% of the patients in the target group showed some positive response to reboxetine, in comparison with 24% in the control group (p<0.01). Mean total score of SANS in the reboxetine group decreased significantly from 79.94±1.20 to 74.23±4.07 (p<0.0001) at the end of the study, while such an improvement was not significant in the placebo group with a decrement from 80.42±2.46 to 79.08±5.83 (p<0.29). Between-group analysis, as well, showed that the mean total score of SANS in the reboxetine group, in comparison with the control group, improved significantly at 8 and 12 weeks (p<0.03 and p<0.01 respectively). Repeated-measures analysis of variance (ANOVA) showed significant improvement of SANS in the reboxetine group (p<0.02), and also a significant difference in this regard between groups (p<0.001). Changes of SAPS were insignificant in both groups. Effect size (ES) analysis for changes of SANS at the end of assessment indicated a large improvement with reboxetine (Cohen's d = 2.91). Post-hoc power analysis showed a power equal to 0.53 (intermediary) for this trial. Conclusion: Reboxetine, as adjuvant to...
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 12 th 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.
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