title: Naltrexone augmentation of neuroleptics in schizophrenia.
abstract: This study was conducted to determine whether the addition of naltrexone to ongoing neuroleptic treatment would facilitate the reduction in positive or negative symptoms in patients with schizophrenia. Twenty-one 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 randomized to receive either placebo or naltrexone 200 mg/day for 3 weeks in addition to their neuroleptic. Patients randomized initially into the placebo arm were crossed over to receive naltrexone in a single-blind fashion for 3 additional weeks. All patients were rated weekly with the Brief Psychiatric Rating Scale (BPRS). Fifteen patients received placebo and six received naltrexone in the first 3 weeks. No significant effects of naltrexone on total BPRS scores or BPRS subscale scores were observed. Patients who received naltrexone on a single-blind basis at the end of the placebo-controlled trial demonstrated a transient exacerbation 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 drug by time effect. Repeated-measures ANOVA on the BPRS Withdrawal-Retardation 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 addressed.
authors.affiliation: Neuropsychiatry Program, VA Connecticut Health Care System, West Haven Campus 06516, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Sernyak
authors.forename: W M
authors.initials: WM
authors.lastname: Glazer
authors.forename: G R
authors.initials: GR
authors.lastname: Heninger
authors.forename: D S
authors.initials: DS
authors.lastname: Charney
authors.forename: S W
authors.initials: SW
authors.lastname: Woods
authors.forename: I L
authors.initials: IL
authors.lastname: Petrakis
authors.forename: J H
authors.initials: JH
authors.lastname: Krystal
authors.forename: L H
authors.initials: LH
authors.lastname: Price
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D010054:Brief Psychiatric Rating Scale; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005476:Fluphenazine / Q000627:therapeutic use; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D009292:Narcotic Antagonists; D009271:Naltrexone; D006220:Haloperidol; D005476:Fluphenazine