만성정신분열병에서 Alprazolam 병용치료효과

Effects of Alprazolam - Combination Therapy in Chronic Schizophrenia

This study had been conducted to elucidate the adjunctive antipsychotic effects of alprazolam in chronic schizophrenia. Thirty-eight hospitalized chronic schizophrenic patients who met DSM-III criteria and had been refractory to standard neuroleptic treatment were selected. The patients were subdivided into two groups; alprazolam combined group and placebo combined group. The duration of study is 7 weeks after two weeks’ washout period. The study consists of 3 stages-the 1st stage is two weeks’ period of dose increment, the 2nd stage is two weeks’ period of maintenance and the 3rd stage is three weeks’ tapering period. The clinical effect had been evaluated at four different time points-the beginning of the 1st week, the end of the 2nd week, the end of the 4th week and the end of the 7th week-by two psychiatrist who were blind for the nature of drugs administerd. The instruments for evaluation were Brief Psychiatric Rating Scale (BPRS) and Abrams-Taylor Rating Scale for Emotional Blunting (ATRS). The results were as follows: 1) Alprazolam combined group showed no significant difference in total scores and four subgroups， scores of BPRS, compared with placebo combined group during 7 weeks. 2) We found no significant changes in total BPRS scores and four subgroups，scores in the alprazolam combined group during the study. 3) There was significant difference between two groups in the evaluation of ARTS done at the time point of 4th week but the scores of alprazolam combined group were higher than those of placebo combined group. 4) Scores of ATRS and withdrawal-retardation subgroup in BPRS were shown to be increased during 1st and 2nd stages and decreased during 3rd stage, supposed to be due to sedative effect of alprazolam. From this study, we could not find any difference between alprazolam and placebo in the adjunctive antipsychotic effects in our study population. In order to more clarify the adjunctive antipsychotic effects of alprazolam, high-dose of alprazolam, longer duration and large sample size may be necessary.