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Treatment of Negative Symptoms in Schizophrenia with Amisulpride

Published online by Cambridge University Press:  02 January 2018

P. Boyer*
Affiliation:
Inserm, Hôpital St-Anne, Paris
Y. Lecrubier
Affiliation:
Inserm U302, Hôpital de la Salpêtrière, Paris
A. J. Puech
Affiliation:
Département de Pharmacologie Clinique, Hôpital de la Salpêtrière, Paris
J. Dewailly
Affiliation:
Laboratoires Delagrange, Paris
F. Aubin
Affiliation:
Département de Pharmacologie Clinique, Hôpital de la Salpêtrière, Paris
*
Dr D. Boyer, Hôpital St-Anne, 100 rue de la Santé, F75014 Paris, France

Abstract

Background

The efficacy of low doses of certain neuroleptics in improving negative symptoms is still controversial. This study assessed the efficacy of amisulpride, a benzamide which increases dopaminergic transmission at low doses via presynaptic dopamine receptor blockade, on negative symptoms of schizophrenia.

Method

The study was designed as a parallel-group, double-blind, placebo-controlled trial. Patients had to fulfil DSM–III criteria for schizophrenia, Andreasen's criteria for negative schizophrenia, and to have a total score of at least 75 on the SANS; those treated with neuroleptics or antidepressants underwent a six-week placebo wash-out. One hundred and four in-patients were randomly assigned to amisulpride 100 mg/d, amisulpride 300 mg/d, or placebo for six weeks; 85 patients completed the study.

Results

Both amisulpride doses were significantly more effective than placebo on the primary evaluation criterion (SANS total score, MANOVA P < 0.02). No significant changes were found in positive symptoms or in extrapyramidal symptoms.

Conclusions

Negative symptoms can be improved by low doses of amisulpride, favouring the hypothesis of dopaminergic hypofunction as one of the causes of negative symptoms.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

Alfredson, G., Harnryd, D. C. & Wiesel, F. A. (1985) Effects of sulpiride and chlorpromazine on autistic and positive psychotic symptoms in schizophrenic patients. Relationship to drug concentration. Psychopharmacology, 85, 813.CrossRefGoogle Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III) Washington, DC: APA.Google Scholar
Andreasen, N. C. & Olsen, S. (1982) Negative vs positive schizophrenia: definition and validation. Archives of General Psychiatry, 39, 789794.Google Scholar
Angrist, B., Rotrosen, J. & Gershon, S. (1980) Differential effects of amphetamine and neuroleptics on negative vs positive symptoms in schizophrenia. Psychopharmacology, 72, 1719.Google Scholar
Bischof, S., Christen, P. & Vassout, A. (1988) Blockade of hippocampal dopamine receptors: a tool for antipsychotics with low extrapyramidal side effects. Progress in Neuropsychopharmacology and Biological Psychiatry, 12, 445467.Google Scholar
Boyer, P. (1986) Etude de l'efficacité de faibles doses de neuroleptiques atypiques (benzamides) dans les états déficitaires. Annales Médico-Psychologiques, 144, 593599.Google Scholar
Boyer, P. & Puech, A. J. (1987) Determinants for clinical activity of neuroleptic drugs: chemical substances, doses, assessment tools. Psychiatry and Psychobiology, 2, 296305.Google Scholar
Breier, A., Wolkowitz, O. M., Doran, A. R., et al (1987) Neuroleptic responsivity of negative and positive symptoms in schizophrenia. American Journal of Psychiatry, 144, 15491555.Google Scholar
Carpenter, W. T., Heinrichs, D. W. & Wagman, A. M. I. (1988) Deficit and nondeficit forms of schizophrenia: the concept. American Journal of Psychiatry, 145, 578583.Google Scholar
Chivers, J. K., Gommeren, W., Leysen, J. E., et al (1988) Comparison of the in-vitro receptor selectivity of substituted benzamide drugs for brain neurotransmitter receptors. Journal of Pharmacy and Pharmacology, 40, 415421.CrossRefGoogle ScholarPubMed
Crow, T. J. (1980) Molecular pathology of schizophrenia: more than one disease process? British Medical Journal, 280, 6668.Google Scholar
Goldberg, S. C. (1985) Negative and deficit symptoms in schizophrenia do respond to neuroleptics. Schizophrenia Bulletin, 11, 453456.Google Scholar
Guyon, A., Assouly-Besse, F., Biala, G., et al (1993) Potentiation by low doses of selected neuroleptics of food-induced conditioned place preference in rats. Psychopharmacology, 110, 460466.Google Scholar
Kane, J. M., Rifkin, A., Wierner, M., et al (1985) High-dose versus low-dose strategies in the treatment of schizophrenia. Psychopharmacology Bulletin, 21, 533537.Google Scholar
Lecrubier, Y. & Douillet, P. (1983) Neuroleptics and the bipolar dopaminergic hypothesis of schizophrenia. In Special Aspects of Psychopharmacology (eds Ackenheil, M. & Matussek, N.), pp. 375381. Paris: Expansion Scientifique Française.Google Scholar
Meltzer, H. Y., Sommers, A. A. & Luchins, D. J. (1986) The effect of neuroleptics and other psychotropic drugs on negative symptoms in schizophrenia. Journal of Clinical Psychopharmacology, 6, 329338.Google Scholar
Petit, M., Zann, M. & Colonna, L. (1984) Etude contrôlée de l'effet désinhibiteur de faibles doses de sulpiride dans les psychoses schizophréniques déficitaires. L'Encéphale, X, 2528.Google Scholar
Pichot, P. & Boyer, P. (1989) A controlled double-blind multicentre trial of high dose amisulpride versus haloperidol in acute psychotic states. In Amisulpride (eds Borenstein, et al), pp. 8392. Paris: Expansion Scientifique Française.Google Scholar
Puech, A. J., Rioux, P., Poncelet, M., et al (1981) Pharmacological properties of new antipsychotic agents: use of animal models. Neuropharmacology, 20, 12791284.Google ScholarPubMed
Sokoloff, P., Giros, B., Martres, M. P., et al (1990) Molecular cloning and characterization of a novel dopamine receptor (D3) as a target for neuroleptics. Nature, 347, 146151.Google Scholar
Vasse, M., Protais, P., Costentin, J., et al (1985) Unexpected potentiation by discriminant benzamide derivatives of sterotyped behaviours elicited by dopamine agonists in mice. Archives of Pharmacology, 329, 108116.Google Scholar
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