Abstract:
Introduction: Negative symptoms are among the important barriers against psychosocial rehabilitation of schizophrenic patients. Adjunctive drugs can be used for reducing the severity of these symptoms. In this study, we compared the helpfulness of Tricyclic antidepressants (TCAs) vs. Specific serotonin reuptake inhibitors (SSRIs) as regards their efficacy on reducing the severity of such symptoms.
Materials and method: One hundred and thirty five schizophrenic patients were divided into three different groups and the efficacy of TCAs (clomipramine, nortriptyline, maprotiline) and SSRIs (flouxetine, citalopram, fluvoxamine), as adjuvant drugs, were examined in three different double-blind clinical controlled trials. Estimation of negative symptoms by Scale for Assessment of Negative Symptoms (SANS) was performed at baseline, week 3 and week 6. The data were analyzed by z and chi-square (X
2-test) formula.
Results: Clomipramine and Nortriptyline could reduce the severity of negative symptoms in some cases to a greater degree than SSRIs (40% versus 20% reduction from baseline). Generally, larger quantity of patients gained benefit from TCAs (73.33%) vis-à-vis SSRIs (65.90%). No important side effect or worsening of positive symptoms was evident in our samples throughout the aforesaid trials.
Conclusion: In severe cases of deficit syndrome, TCAs seem to be superior to SSRIs for amelioration of negative symptoms.