Adjunctive alprazolam for schizophrenia with panic anxiety: clinical observation and pathogenetic implications

Kahn, Jeffrey P.; Ma, Puertollano; Schane,; Df, Klein

doi:10.1176/ajp.145.6.742

Cited by 49 publications

(2 citation statements)

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“…Data from pharmaceutical treatment trials are also indicative of the biological etiology of schizophrenia and panic. For example, traditional antipsychotics may worsen panic symptoms in patients with schizophrenia and comorbid panic disorder (Kahn and Meyers, 2000), whereas adjunctive alprazolam or clonazepam may reduce both panic symptoms and psychosis symptoms (Kahn et al, 1988). More recently, researchers have noted the positive effects of atypical antipsychotics as well (Takahashi et al, 2001; Takahashi et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Schizophrenia comorbid with panic disorder: Evidence for distinct cognitive profiles

Rapp

White-Ajmani

Antonius

et al. 2012

Psychiatry Research

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Patients with comorbid schizophrenia and panic symptoms share a distinct clinical presentation and biological characteristics, prompting some to propose panic psychosis as a separate subtype of schizophrenia. Less is known about these patients’ neuropsychological profiles, knowledge of which may facilitate target-specific treatments and research into the etiopathophysiology for such cases. A total of 255 schizophrenia patients with panic disorder (n=39), non-panic anxiety disorder (n=51), or no anxiety disorder (n=165) were assessed with the Wechsler Adult Intelligence Scale – Revised, the Wisconsin Card Sorting Test, the Trail Making Test, the Controlled Oral Word Association Test, the Animal Naming subtest of the Boston Diagnostic Aphasia Examination, and the Wechsler Memory Scale – Revised. Psychotic symptoms were assessed with the Positive and Negative Syndrome Scale. Patients with panic disorder demonstrated a higher verbal IQ and better problem solving, set switching, delayed recall, attention, and verbal fluency as compared to schizophrenia patients without comorbid anxiety. The schizophrenia-panic group reported a higher level of dysthymia on stable medication. Our findings suggest that patients with schizophrenia and comorbid panic disorder exhibit distinct cognitive functioning when compared to other schizophrenia patients. These data offer further support for a definable panic-psychosis subtype and suggest new etiological pathways for future research.

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Section: Introductionmentioning

confidence: 99%

Schizophrenia comorbid with panic disorder: Evidence for distinct cognitive profiles

Rapp

White-Ajmani

Antonius

et al. 2012

Psychiatry Research

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“…In earlier studies, a significant correlation between PTSD scores and psychopathology scores for schizophrenia was found reflecting a higher severity of psychopathology in schizophrenic patients with comorbid PTSD. [3042434445] Similarly, a significant correlation was found between the GAD-7 scores and the general psychopathology scale of PANSS. [5] As in the current study, majority of the study sample belonged to the group of chronic schizophrenics, which is different from the other studies with patients mostly belonging to acute schizophrenia and may explain the differences in the results with the other studies.…”

Section: Discussionmentioning

confidence: 95%

Correlates and management of comorbid anxiety disorders in schizophrenia

Kiran

2018

Ind Psychiatry J

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Background: Only a few studies have examined the treatability of anxiety disorders in schizophrenia, even though it is generally accepted that in the absence of schizophrenia, the anxiety disorders are safely and effectively treatable. Aim: The aim of this study was to study the relation of anxiety disorders with the positive and negative symptoms of schizophrenia and the effect of treatment of different anxiety disorders in schizophrenia patients. Materials and Methods: The study was carried out on inpatients of a tertiary care psychiatric hospital using a purposive sampling technique. The schizophrenia patients were evaluated for psychopathology and the presence of anxiety disorder at baseline. After being prescribed with antipsychotic medication in a suitable dose for 8 weeks, they were followed up at monthly intervals for the course of both schizophrenia and anxiety disorders. Thereafter, an selective serotonin reuptake inhibitor (SSRI) was also prescribed to the schizophrenia patients with comorbid anxiety disorder, and the patients were again followed up for a period of 8 weeks to assess the progress of schizophrenia and anxiety disorder. Results: The prevalence of anxiety disorder in 93 schizophrenia patients included in the present study was 45.16%. The most common comorbid anxiety disorders in schizophrenia patients were panic disorder (18.27%), social anxiety disorder (9.68%), obsessive-compulsive disorder (8.60%), and agoraphobia (6.45%). Schizophrenia patients with anxiety disorder had a significantly higher positive score of the Positive and Negative Symptom Scale for Schizophrenia (PANSS) and a significantly lower score on the negative scale and the general psychopathology scale of the PANSS, as compared to the scores of the schizophrenia group without anxiety disorders. Schizophrenia patients with anxiety disorders responded well to the combination of SSRIs and antipsychotics but not antipsychotics alone. Conclusions: Comorbid anxiety disorders are common in schizophrenia. Schizophrenia patients with anxiety disorders differ significantly from those without anxiety disorders in their basic psychopathology. These anxiety disorders are quite responsive to the SSRIs but not to antipsychotics alone. Further, there is a shorter duration of illness in schizophrenia patients with anxiety disorders as compared to schizophrenia patients without anxiety disorders assigning a prognostic significance to the presence of comorbid anxiety disorders in schizophrenia.

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