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Adjunctive imipramine maintenance in post-psychotic depression/negative symptoms
S G Siris1, S E Mason, P C Bermanzohn
1Hillside Hospital Division of the Long Island Jewish Medical Center, Glen Oaks, NY 11004.
Psychopharmacology Bulletin
|January 1, 1990
Summary
Maintaining imipramine treatment is recommended for patients with schizophrenia experiencing post-psychotic depression or negative symptoms. Imipramine maintenance prevented relapse into these debilitating states, unlike placebo.
Area of Science:
- Psychiatry and Neuropharmacology
- Clinical Psychology
Background:
- Schizophrenia and schizoaffective disorder can present with persistent post-psychotic depression or negative symptoms.
- These symptoms are often refractory to standard treatments, including antiparkinsonian agents like benztropine.
Purpose of the Study:
- To evaluate the efficacy of maintaining adjunctive imipramine treatment in stable patients with schizophrenia or schizoaffective disorder.
- To assess the impact of imipramine maintenance on preventing relapse of post-psychotic depression or negative symptoms.
Main Methods:
- A double-blind, placebo-controlled maintenance trial was conducted.
- Fourteen patients with schizophrenia/schizoaffective disorder and responsive negative symptoms/post-psychotic depression were included.
- Patients received stable doses of fluphenazine decanoate and benztropine, with adjunctive imipramine or placebo.
Main Results:
- Six of six patients tapered to placebo relapsed into depression-like, negative symptoms.
- Only 2 of 8 patients maintained on imipramine experienced relapse (p = .009, favoring imipramine).
- No patients receiving imipramine maintenance relapsed into psychosis.
Conclusions:
- Adjunctive imipramine maintenance is advisable for stable patients with schizophrenia or schizoaffective disorder experiencing post-psychotic depression or negative symptoms.
- Continued imipramine treatment, alongside neuroleptic and antiparkinsonian medication, effectively prevents relapse of these specific symptom clusters.