ABSTRACT
Thirteen outpatients with chronic but stable schizophrenia received donepezil and placebo augmentation of their maintenance antipsychotic medication regimen. Each subject received in a randomized, counterbalanced order 1) donepezil 5 mg for 6 weeks then donepezil 10 mg for six weeks and 2) placebo donepezil for 12 weeks. Serial ratings of the Positive and Negative Symptom Scale (PANSS) [Kay, S.R., Fiszbein, A., Opler, L.A., 1987. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13(2): 261-276] were performed by a trained rater blind to the donepezil order and condition: at baseline, 12 weeks and 24 weeks. On donepezil as compared to baseline or placebo, there was a significant improvement in PANSS negative scores (p=.018, n=13). These results are discussed with respect to other studies using cholinesterase inhibitors as an augmentation strategy in schizophrenia.
Subject(s)
Antipsychotic Agents/administration & dosage , Cholinesterase Inhibitors/administration & dosage , Indans/administration & dosage , Nootropic Agents/administration & dosage , Piperidines/administration & dosage , Psychotic Disorders/drug therapy , Schizophrenia/drug therapy , Schizophrenic Psychology , Adult , Antipsychotic Agents/adverse effects , Benzodiazepines/administration & dosage , Benzodiazepines/adverse effects , Cholinesterase Inhibitors/adverse effects , Clozapine/administration & dosage , Clozapine/adverse effects , Cross-Over Studies , Donepezil , Double-Blind Method , Drug Therapy, Combination , Female , Humans , Indans/adverse effects , Male , Middle Aged , Nootropic Agents/adverse effects , Olanzapine , Piperidines/adverse effects , Psychiatric Status Rating Scales , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Risperidone/administration & dosage , Risperidone/adverse effects , Schizophrenia/diagnosis , Treatment OutcomeABSTRACT
Donepezil, 5 mg/d for 6 wk then 10 mg/d for 6 wk, and placebo daily for 12 wk in a double-blind cross-over paradigm, was added to the therapeutic regimen of 13 patients with schizophrenia or schizoaffective disorders, clinically stable on atypical antipsychotic medications. Patients had varying degrees of depressive symptoms, ranging from no depression to clinically significant depression. There was no worsening or induction of depression in individual patients or the group as a whole. In addition there was a statistically significant antidepressant effect in the group as a whole during the donepezil condition and a clinically significant antidepressant effect in the patients with clinically significant depressive symptoms, although there were not enough depressed patients in the group to conclude that donepezil may have antidepressant effects. Thus, in this study, donepezil did not induce or worsen depressive symptoms in schizophrenic and schizoaffective disorder patients.
