NALTREXONE AUGMENTATION OF NEUROLEPTICS IN SCHIZOPHRENIA

This study was conducted to determine whether the addition of naltrexo ne to ongoing neuroleptic treatment would facilitate the reduction in positive or negative symptoms in patients with schizophrenia. Twenty-o ne patients meeting DSM-III criteria for schizophrenia were enrolled; all patients had been stabilized for at least 2 weeks on their dosage of neuroleptic medicine before entering the study. Patients were rando mized to receive either placebo or naltrexone 200 mg/day for 3 weeks i n addition to their neuroleptic. Patients randomized initially into th e placebo arm were crossed over to receive naltrexone in a single-blin d fashion for 3 additional weeks. All patients were rated weekly with the Brief Psychiatric Rating Scale (BPRS). Fifteen patients received p lacebo and six received naltrexone in the first 3 weeks. No significan t effects of naltrexone on total BPRS scores or BPRS subscale scores w ere observed. Patients who received naltrexone on a single-blind basis at the end of the placebo-controlled trial demonstrated a transient e xacerbation in negative symptoms as reflected by the total BPRS score and the BPRS Withdrawal-Retardation subscale score. Repeated-measures analysis of variance (ANOVA) on the BPRS total Score of the subsequent treatment with naltrexone showed a trend for a significance in the dr ug by time effect. Repeated-measures ANOVA on the BPRS Withdrawal-Reta rdation subscale of the subsequent treatment with naltrexone showed a significant drug by time effect. The current data failed to indicate a clinical benefit when naltrexone was added to the neuroleptic regimen . Other potential applications of naltrexone in schizophrenia are addr essed.