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Sulpiride augmentation in people with schizophrenia partially responsive to clozapine

A double-blind, placebo-controlled study

Published online by Cambridge University Press:  02 January 2018

Roni Shiloh
Affiliation:
Geha Psychiatric Hospital, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University
Zvi Zemishlany
Affiliation:
Geha Psychiatric Hospital, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University
Dov Aizenberg
Affiliation:
Geha Psychiatric Hospital, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University
Marguerite Radwan
Affiliation:
Geha Psychiatric Hospital, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University
Bruria Schwartz
Affiliation:
Geha Psychiatric Hospital, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University
Pnina Dorfman-Etrog
Affiliation:
Geha Psychiatric Hospital, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University
Ilan Modai
Affiliation:
Geha Psychiatric Hospital, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University
Marina Khaikin
Affiliation:
Geha Psychiatric Hospital, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University
Abraham Weizman*
Affiliation:
Geha Psychiatric Hospital, Rabin Medical Center, and Felsenstein Medical Research Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University, Israel
*
Professor A. Weizman, Geha Psychiatric Hospital, P.O.B. 102; Petah Tiqva, 49100, Israel; Fax: 972-3-9241041

Abstract

Background

We hypothesised that a combined regimen of clozapine, a relatively weak D2-dopaminergic antagonist, and sulpiride, a selective D2 blocker, would demonstrate a greater antipsychotic efficacy by enhancing the D2 blockade of clozapine.

Method

Twenty-eight people with schizophrenia, previously unresponsive to typical antipsychotics and only partially responsive to current treatment with clozapine, received, double-blind, 600 mg/day sulpiride or placebo, in addition to an ongoing clozapine treatment. The clinical status was evaluated before, during, and at the end of 10 weeks of sulpiride addition using the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms, and Hamilton Rating Scale for Depression.

Results

The clozapine–sulpiride group exhibited substantially greater and significant improvements in positive and negative psychotic symptoms. About half of them, characterised by a younger age and lower baseline SAPS scores, had a mean reduction of 42.4 and 50.4% in their BPRS and SAPS scores, respectively.

Conclusions

A subgroup of patients with chronic schizophrenia may substantially benefit from sulpiride addition to clozapine.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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