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Methylphenidate, dextroamphetamine, and levamfetamine. Effects on schizophrenic symptoms

D S Janowsky, J M Davis

    Archives of General Psychiatry
    |March 1, 1976
    PubMed
    Summary

    Methylphenidate, dextroamphetamine, and levamfetamine can help evaluate neurotransmitter roles in schizophrenia. Methylphenidate most effectively worsened psychotic symptoms in patients, suggesting dopamine and norepinephrine involvement.

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    Area of Science:

    • Neuroscience
    • Psychiatry
    • Pharmacology

    Background:

    • Schizophrenia is a complex psychiatric disorder.
    • Neurotransmitter systems, particularly dopamine and norepinephrine, are implicated in schizophrenia.
    • Pharmacologic agents can serve as tools to investigate these neurotransmitter roles.

    Purpose of the Study:

    • To evaluate methylphenidate hydrochloride, dextroamphetamine sulfate, and levamfetamine succinate as tools for assessing neurotransmitter involvement in schizophrenia.
    • To compare the efficacy of these agents in activating psychotic symptoms in actively ill schizophrenic patients.

    Main Methods:

    • Equimolar doses of methylphenidate, dextroamphetamine, and levamfetamine were administered to schizophrenic patients.
    • The intensity of pre-existing psychotic symptoms (hallucinations, delusions) was observed and compared between agents.

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  • Literature review was conducted to contextualize findings.

    • Main Results:

    • Methylphenidate administration led to a clear intensification of psychotic symptoms.
    • Methylphenidate was more effective in activating symptoms than dextroamphetamine, which was more effective than levamfetamine.
    • Levodopa (L-dopa) also reportedly worsens schizophrenic symptoms.

    Conclusions:

    • Findings support the role of dopamine and norepinephrine in activating schizophrenic symptoms.
    • Complexities remain, particularly regarding methylphenidate's differential effects compared to animal models.
    • The procedure has occasional and limited potential for differential diagnosis and selective therapy in schizophrenia.