تاثير سيتالوپرام ، آلپرازولام و كلوميپرامين در كاهش علايم منفي بيماران مبتلا به اسكيزوفرنيا

Effectiveness of citalopram, alprazolam and clomipramine in amelioration of negative symptoms in schizophrenia

Introduction: Negative symptoms of schizophrenia are among the major barriers against rehabilitation of such patients and hinder their appropriate communication with othersʹ. Using of adjunctive drugs in addition to current treatments may reduce these symptoms. In this research we have discussed the efficacy of citalopram, clomipramine and alprazolam in reducing such symptoms. Method and Materials: Forty male, randomly chosen, schizophrenic patients who have been and are hospitalized for life long residential care in razi psychiatric hospital, had been chosen for a Double-Blind study (CCT) and divided into four groups: and treated with 20 mg citalopram, 0175 mg alprazolam., 25 mg clomipramine and placebo, respectively, in addition to current treatments (typical antipsychosis). After two weeksʹ there was doubling of foresaid doses, which continued for another two weeks, and then tapered and terminated. Existence and severity of negative symptoms had been measured with the scale of SANS in the beginning and before applying of adjunctive drugs, and then at the end of second week of therapy, and finally at the end of fourth week During these research no ,side effect had led to distress for patients. Data has been .surveyed according to Z and chisquare (X2-test) formula for comparing of variables. Results: Citalopram, alprazolam, and clomipramine have decreased the severity of negative symptoms, respectively, in 80%, 50% and 50% of patients. In the majority of these patients these decrease has been restricted to 20% from baseline. Only clomipramine could derease up to 40% in two cases. Mean while, clomipramine but, generally these drugs were more efficacious on mild to moderate symptoms (grade 1,2, and 3). Decreasing of symptoms were independent of each other and with variable patterns. There was no statistically important difference between aged and non aged patients. No patient in control group had any benefit from placebo. Conclusion: Theatment with citalopram, alprazolam and clomipramine can result in benefit and decrease of negative symproms in schizophrenic patients. In this regard, overally, the lower side effects and pharmacokinetic interactions of citalopram in comparing with clomipramine and alprazolam deserve attention.