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Amoxapine as an atypical antipsychotic: a comparative study vs risperidone
Rogelio Apiquian1, Ana Fresan, Rosa-Elena Ulloa
1Department of Psychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Av. Insurgentes Sur 3877, Mexico City, 14296 Mexico. rogelioapiquian@yahoo.com.mx
Summary
Amoxapine demonstrated efficacy comparable to risperidone in treating schizophrenia symptoms. This antidepressant also showed fewer side effects, including less extrapyramidal symptoms and prolactin increase, suggesting it as a cost-effective alternative.
Area of Science:
- Psychiatry and Pharmacology
- Clinical Neuroscience
Background:
- Amoxapine, an antidepressant, exhibits preclinical and in-vitro characteristics similar to atypical antipsychotics.
- Previous open trials suggest amoxapine's potential efficacy in treating psychosis.
Purpose of the Study:
- To compare the antipsychotic efficacy and side effect profiles of amoxapine and risperidone.
- To evaluate amoxapine as a potential atypical antipsychotic treatment for schizophrenia.
Main Methods:
- A 6-week, double-blind, randomized trial involving 48 acutely psychotic schizophrenia patients.
- Patients received either amoxapine (up to 250 mg/day) or risperidone (up to 5 mg/day).
- Standardized weekly assessments measured positive, negative, affective symptoms, motor side effects, and prolactin levels.
Main Results:
- Both amoxapine (mean 228.0 mg/day) and risperidone (mean 4.5 mg/day) achieved equivalent improvements in positive, negative, and depressive symptoms.
- Amoxapine was associated with significantly lower extrapyramidal symptoms (EPS) and less prolactin elevation compared to risperidone.
- 39 patients completed the trial (22 on amoxapine, 21 on risperidone).
Conclusions:
- Amoxapine is effective in treating acute schizophrenia symptoms, supporting its role as an atypical antipsychotic.
- Amoxapine offers a favorable side effect profile compared to risperidone, with reduced EPS and prolactin increase.
- As an off-patent medication, amoxapine presents a valuable, low-cost alternative to newer atypical antipsychotics, especially in resource-limited settings.