Effects of sulpiride and chlorpromazine on depressive symptoms in schizophrenic patients ? relationship to drug concentrations

Abstract

Schizophrenic patients were treated with fixed doses of sulpiride (800 mg/day) or chlorpromazine (CPZ) (400 mg/day) over a period of 8 weeks using a double-blind design. There were 25 patients in each group and all the patients were in an acute phase of their disease. They all fulfilled the Research Diagnostic Criteria (RDC) for schizophrenia. Depressive symptoms as rated according to the Comprehensive Psychopathological Rating Scale (CPRS) were present in the patients before treatment was started. The depressive and psychotic symptoms in both groups decreased in parallel during the whole period of treatment. Patients in the sulpiride group recovered more quickly from depressive symptoms than patients in the CPZ group. It was also found that patients with low concentrations of sulpiride or CPZ in serum recovered more completely from depressive symptoms and had fewer extrapyramidal side effects than patients with high drug concentrations.

Dopamine and Pain Sensitivity: Neither Sulpiride nor Acute Phenylalanine and Tyrosine Depletion Have Effects on Thermal Pain Sensations in Healthy Volunteers

“…Further, in vivo microdialysis studies demonstrate increased dopamine release induced by sulpiride in the striatum and medial prefrontal cortex [ 32 , 42 ]. In humans, the notion of predominant pre-synaptic effects of sulpiride is supported by antidepressive effects at low doses of sulpiride [ 33 , 43 ].…”

Factors associated with depression in patients with schizophrenia

“…On the contrary, there are also researches to state that antipsychotic drug-induced depression is controversial. there is no relation between depressive symptoms of schizophrenia patients and neuroleptic dose, use of administration, plasma and BOS levels (16). There are also studies to show when patients with and without antipsychotic treatment were compared; there were no significant differences regarding depression incidence (17).…”

Elderly Patients with Schizophrenia and Depression: Diagnosis and Treatment

“…One trial found no significant differences between quetiapine and haloperidol (92). In a second trial, sulpride was compared to chlorpromazine; the group treated with sulpride had more reductions in depressive symptoms based on scores of the Comprehensive Psychopathologic Rating Scale (93). In a third trial, Jasovic (94) used Hamilton Depression Rating Scale scores to compare clozapine to any other antipsychotic plus an antidepressant; use of clozapine lead to greater reductions in Hamilton symptoms.…”