The Effect of Paroxetine in Chronic Schizophrenic Inpatients with Depressive Symptoms: A Double-Blind Placebo-Controlled Study / 신경정신의학

ABSTRACT

OBJECTIVES: This double-blind placebo-controlled study was conducted to demonstrate the improvement of depressive, positive and negative symptoms, and general psychopatholgy in depressed chronic schizophrenic inpatients with adjunctive paroxetine 20mg therapy in the morning. METHODS: Forty nine chronic schizophrenic inpatients with depressive symptoms were randomly received adjunctive paroxetine or placebo for 6 week study period. Therapeutic effect and side effects were evaluated by means of the Hamilton Rating Scale for Depression (HRSD), the Brief Psychiatric Rating Scale (BPRS), the Positive and Negative Syndrome Scale (PANSS), the Extrapyramidal Symptom Rating Scale (ESRS), the UKU side effect rating scale (UKU), and the Clinical Global Impression (CGI) at baseline, first, second, forth, and sixth week of treatment in a controlled double-blind design. RESULTS: 18 patients completed six weeks of paroxetine therapy, and 18 patients placebo therapy. 1) Comparison between paroxetine and placebo groups (1) HRSD total scores in both groups were significantly decreased (p< 01) but there was no statistically significant difference between 2 groups. This study showed that significant effect in paroxetine group appeared at 2nd week of treatment (p< 01), while in placebo group at 4th week of treatment (p< 01). (2) PANSS, BPRS, CGI, ESRS, and UKU In both groups, PANSS total scores and CGI scores were significantly decreased respectively (p< 01, p< 05) and thus indicated the improvement of global psychopathology and entire effects. There were no significant differences between 2 groups in positive, negative symptoms, general psychopathology, and drug side effects. 2) Comparison between responding and nonresponding groups in paroxetine adjunctive therapy (1) Compared with nonresponding group, responding group had significant decrease in HRSD total score (p< 01), in HRSD subitems such as depressed mood, suicide, psychic anxiety, and feelings of guilt (p< 01), and in other subitems such as work and activity, early insomnia, and hypochondriasis (p< 05). (2) Compared with nonresponding group, responding group had significantly decrease in BPRS total score (p< 01) and in general subscale of PANSS (p< 05). CONCLUSION: The results suggest that both paroxetine and placebo groups were improved in depressive symptoms, but paroxetine group had more rapid improvement than placebo group. There were no significant differences in positive symptoms, negative symptoms, general psychopathology, and drug side effects between two groups. Compared with nonresponding group in paroxetine adjunctive therapy, responding group had significant improvement in depressive symptoms and general psychopathology.