Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Treatment of Secondary Depression in Schizophrenia: A Double-blind, Placebo-Controlled Trial of Amitriptyline Added to Perphenazine

Treatment of Secondary Depression in Schizophrenia: A Double-blind, Placebo-Controlled Trial of... Abstract • The combination of antidepressants and neuroleptics has been widely recommended and commonly used clinically for the schizophrenic patient who becomes depressed. However, the value of the combination for these patients has not been clearly demonstrated. This report presents results of a double-blind, randomized, placebo-controlled clinical trial designed to evaluate the combination of perphenazine and amitriptyline hydrochloride with that of perphenazine alone in the treatment of 35 ambulatory chronic schizophrenic patients in whom depressive symptoms developed. Results showed that the addition of amitriptyline to perphenazine, when compared with perphenazine alone, was more effective in reducing symptoms of depression after four months of treatment, but less effective in reducing thought disorder. The study concludes that the value of adding an antidepressant to the usual neuroleptic in the treatment of secondary depression in schizophrenia should be reviewed. References 1. Bowers MB, Astrachan BM: Depression in acute schizophrenic psychosis . Am J Psychiatry 123:976-979, 1967. 2. McGlashan TH, Carpenter WT: Postpsychotic depression in schizophrenia . Arch Gen Psychiatry 33:231-239, 1976.Crossref 3. Cohen S, Calista LV, Farberow NL, et al: Tranquilizers and suicide in the schizophrenic patient . Arch Gen Psychiatry 11:312-321, 1964.Crossref 4. Waines H: Suicide in schizophrenics . Dis Nerv System 29:35-40, 1968. 5. Raskin DE: Masked depression in chronic schizophrenia . Psychiatr Q 44:575-582, 1970.Crossref 6. Sonnenberg SM, Miller JB: Depression in resolving schizophrenia . Psychother Theory Res Pract 7:111-117, 1970.Crossref 7. Rorn S: The seemingly ubiquitous depression following acute schizophrenic episodes: A neglected area of clinical discussion . Am J Psychiatry 127:51-58, 1970. 8. Davis JM: Overview: Maintenance therapy in psychiatry: 1. Schizophrenia . Am J Psychiatry 132:1237-1245, 1975. 9. Extein I, Bowers MB: The pharmacologic meaning of successful antipsychotic-antidepressive combinations . Compr Psychiatry 16:427-434, 1975.Crossref 10. Winstead DK, Blackwell B, Eilers MK, et al: Psychotropic drug use in five city hospitals . Dis Nerv System 37:504-509, 1976. 11. Freeman S: The therapeutic value of combinations of psychotropic drugs: A review . Psychopharmacol Bull 4:1-27, 1967. 12. Hedberg DL, Houck JH, Glueck BG: Tranycypromine-trifluopenazine combination in the treatment of schizophrenia . Am J Psychiatry 127:1141-1146, 1971. 13. Hanlon TP, Nussbaum K, Wittig B, et al: The comparative effectiveness of amitriptyline, perphenazine and their combination in the treatment of chronic psychotic patients . J New Drugs 4:52-60, 1964.Crossref 14. Chouinard G, Annable L, Serrano M, et al: Amitriptyline-perphenazine interaction in ambulatory schizophrenic patients: A controlled study of drug interaction . Arch Gen Psychiatry 32:1295-1307, 1975.Crossref 15. Weissman MM, Pottenger M, Kleber H, et al: Symptom patterns in primary and secondary depression: A comparison of primary depressives with depressed opiate addicts, alcoholics, and schizophrenics . Arch Gen Psychiatry 34:854-862, 1977.Crossref 16. American Psychiatric Association: DSMII: Diagnostic and Statistical Manual of Mental Disorders, ed 2. Washington, American Psychiatric Association, 1968. 17. Astrachan BM, Harrow M, Adler D, et al: A checklist for the diagnosis of schizophrenia . Br J Psychiatry 121:529-539, 1972.Crossref 18. Raskin A, Schuterbrandt JG, Reading N, et al: Differential response to chlorpromazine, imipramine and placebo . Arch Gen Psychiatry 23:164-173, 1970.Crossref 19. Overall JE, Gorham DR: The brief psychiatric rating scale . Psychiatr Rep 10:799-812, 1962.Crossref 20. Overall JE, Klett CJ: Applied Multivariate Analysis . New York, McGraw-Hill Book Co Inc, 1972, pp 11-13. 21. Hollister LE, Overall JE, Kimbell I Jr, et al: Specific indications for different classes of phenothiazines . Arch Gen Psychiatry 30:94-99, 1974.Crossref 22. Hamilton M: A rating scale for depression . J Neurol Neurosurg Psychiatry 23:56-62, 1960.Crossref 23. Guy W, Bonato R: Early Clinical Drug Evaluation Unit (ECDEU) Assessment Battery, second revision . Chevy Chase, Md, US Department of Health, Education, and Welfare, Public Health Service, Health Services and Mental Health Administration, National Institutes of Mental Health, 1970. 24. Derogatis LR, Lipman R, Covi L: SCL-90: An outpatient psychiatric scale. Preliminary report . Psychopharmacol Bull 9:13-27, 1973. 25. Schooler N, Hogarty J, Weissman MM, in Hargreaves WA, Attkisson CC, Sorensen JE (eds): Resource Materials for Community Mental Health Program Evaluations , ed 2. US Dept of Health, Education, and Welfare publication ADM 77328, 1977, pp 290-303. 26. Weissman MM, Paykel ES: The Depressed Woman: A Study of Social Relationships . Chicago, University of Chicago Press, 1974. 27. Gurland BJ, Yorkston NJ, Stone AR, et al: The structured and scaled interview to assess maladjustment (SSIAM): I. Description, rationale, and development . Arch Gen Psychiatry 27:259-264, 1972.Crossref 28. Katz M, Lyerly S: Method for measuring adjustment and social behavior in the community: Rationale, description, discriminative validity and scale development . Psychol Rep 13:503-535, 1963.Crossref 29. Cohen S: Psychotropic drug interactions, drug abuse and alcoholism . Newsletter , 1977, vol 6. 30. Horwitz WA: Physiologic responses as prognostic guides in the use of antidepressant drugs . Am J Psychiatry 125:60-68, 1968. 31. Escobar JL Gomez O, Tuason VB: Depressive subtypes, blood pressure changes and response to treatment . Dis Neru System 38:76-79, 1977. 32. Blumberg AG, Klein DF, Pollack M: Effects of chlorpromazine and imipramine on systolic blood pressure in psychiatric patients: Relationships to age, diagnosis and initial blood pressure . J Psychiatr Res 2:51-60, 1964.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Treatment of Secondary Depression in Schizophrenia: A Double-blind, Placebo-Controlled Trial of Amitriptyline Added to Perphenazine

Download PDF
7 pages

Loading next page...
 
/lp/american-medical-association/treatment-of-secondary-depression-in-schizophrenia-a-double-blind-FbPsgj0RLu

References (36)

Publisher
American Medical Association
Copyright
Copyright © 1979 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1979.01780050079010
Publisher site
See Article on Publisher Site

Abstract

Abstract • The combination of antidepressants and neuroleptics has been widely recommended and commonly used clinically for the schizophrenic patient who becomes depressed. However, the value of the combination for these patients has not been clearly demonstrated. This report presents results of a double-blind, randomized, placebo-controlled clinical trial designed to evaluate the combination of perphenazine and amitriptyline hydrochloride with that of perphenazine alone in the treatment of 35 ambulatory chronic schizophrenic patients in whom depressive symptoms developed. Results showed that the addition of amitriptyline to perphenazine, when compared with perphenazine alone, was more effective in reducing symptoms of depression after four months of treatment, but less effective in reducing thought disorder. The study concludes that the value of adding an antidepressant to the usual neuroleptic in the treatment of secondary depression in schizophrenia should be reviewed. References 1. Bowers MB, Astrachan BM: Depression in acute schizophrenic psychosis . Am J Psychiatry 123:976-979, 1967. 2. McGlashan TH, Carpenter WT: Postpsychotic depression in schizophrenia . Arch Gen Psychiatry 33:231-239, 1976.Crossref 3. Cohen S, Calista LV, Farberow NL, et al: Tranquilizers and suicide in the schizophrenic patient . Arch Gen Psychiatry 11:312-321, 1964.Crossref 4. Waines H: Suicide in schizophrenics . Dis Nerv System 29:35-40, 1968. 5. Raskin DE: Masked depression in chronic schizophrenia . Psychiatr Q 44:575-582, 1970.Crossref 6. Sonnenberg SM, Miller JB: Depression in resolving schizophrenia . Psychother Theory Res Pract 7:111-117, 1970.Crossref 7. Rorn S: The seemingly ubiquitous depression following acute schizophrenic episodes: A neglected area of clinical discussion . Am J Psychiatry 127:51-58, 1970. 8. Davis JM: Overview: Maintenance therapy in psychiatry: 1. Schizophrenia . Am J Psychiatry 132:1237-1245, 1975. 9. Extein I, Bowers MB: The pharmacologic meaning of successful antipsychotic-antidepressive combinations . Compr Psychiatry 16:427-434, 1975.Crossref 10. Winstead DK, Blackwell B, Eilers MK, et al: Psychotropic drug use in five city hospitals . Dis Nerv System 37:504-509, 1976. 11. Freeman S: The therapeutic value of combinations of psychotropic drugs: A review . Psychopharmacol Bull 4:1-27, 1967. 12. Hedberg DL, Houck JH, Glueck BG: Tranycypromine-trifluopenazine combination in the treatment of schizophrenia . Am J Psychiatry 127:1141-1146, 1971. 13. Hanlon TP, Nussbaum K, Wittig B, et al: The comparative effectiveness of amitriptyline, perphenazine and their combination in the treatment of chronic psychotic patients . J New Drugs 4:52-60, 1964.Crossref 14. Chouinard G, Annable L, Serrano M, et al: Amitriptyline-perphenazine interaction in ambulatory schizophrenic patients: A controlled study of drug interaction . Arch Gen Psychiatry 32:1295-1307, 1975.Crossref 15. Weissman MM, Pottenger M, Kleber H, et al: Symptom patterns in primary and secondary depression: A comparison of primary depressives with depressed opiate addicts, alcoholics, and schizophrenics . Arch Gen Psychiatry 34:854-862, 1977.Crossref 16. American Psychiatric Association: DSMII: Diagnostic and Statistical Manual of Mental Disorders, ed 2. Washington, American Psychiatric Association, 1968. 17. Astrachan BM, Harrow M, Adler D, et al: A checklist for the diagnosis of schizophrenia . Br J Psychiatry 121:529-539, 1972.Crossref 18. Raskin A, Schuterbrandt JG, Reading N, et al: Differential response to chlorpromazine, imipramine and placebo . Arch Gen Psychiatry 23:164-173, 1970.Crossref 19. Overall JE, Gorham DR: The brief psychiatric rating scale . Psychiatr Rep 10:799-812, 1962.Crossref 20. Overall JE, Klett CJ: Applied Multivariate Analysis . New York, McGraw-Hill Book Co Inc, 1972, pp 11-13. 21. Hollister LE, Overall JE, Kimbell I Jr, et al: Specific indications for different classes of phenothiazines . Arch Gen Psychiatry 30:94-99, 1974.Crossref 22. Hamilton M: A rating scale for depression . J Neurol Neurosurg Psychiatry 23:56-62, 1960.Crossref 23. Guy W, Bonato R: Early Clinical Drug Evaluation Unit (ECDEU) Assessment Battery, second revision . Chevy Chase, Md, US Department of Health, Education, and Welfare, Public Health Service, Health Services and Mental Health Administration, National Institutes of Mental Health, 1970. 24. Derogatis LR, Lipman R, Covi L: SCL-90: An outpatient psychiatric scale. Preliminary report . Psychopharmacol Bull 9:13-27, 1973. 25. Schooler N, Hogarty J, Weissman MM, in Hargreaves WA, Attkisson CC, Sorensen JE (eds): Resource Materials for Community Mental Health Program Evaluations , ed 2. US Dept of Health, Education, and Welfare publication ADM 77328, 1977, pp 290-303. 26. Weissman MM, Paykel ES: The Depressed Woman: A Study of Social Relationships . Chicago, University of Chicago Press, 1974. 27. Gurland BJ, Yorkston NJ, Stone AR, et al: The structured and scaled interview to assess maladjustment (SSIAM): I. Description, rationale, and development . Arch Gen Psychiatry 27:259-264, 1972.Crossref 28. Katz M, Lyerly S: Method for measuring adjustment and social behavior in the community: Rationale, description, discriminative validity and scale development . Psychol Rep 13:503-535, 1963.Crossref 29. Cohen S: Psychotropic drug interactions, drug abuse and alcoholism . Newsletter , 1977, vol 6. 30. Horwitz WA: Physiologic responses as prognostic guides in the use of antidepressant drugs . Am J Psychiatry 125:60-68, 1968. 31. Escobar JL Gomez O, Tuason VB: Depressive subtypes, blood pressure changes and response to treatment . Dis Neru System 38:76-79, 1977. 32. Blumberg AG, Klein DF, Pollack M: Effects of chlorpromazine and imipramine on systolic blood pressure in psychiatric patients: Relationships to age, diagnosis and initial blood pressure . J Psychiatr Res 2:51-60, 1964.Crossref

Journal

Archives of General Psychiatry – American Medical Association

Published: May 1, 1979

There are no references for this article.