title: Reboxetine adjuvant therapy in patients with schizophrenia showing a suboptimal response to clozapine: a 12-week, open-label, pilot study.
abstract: The present 12-week open-label uncontrolled trial was aimed to explore the efficacy of reboxetine add-on pharmacotherapy on clinical symptoms and cognitive functioning in 15 patients with schizophrenia with suboptimal response (mean [SD] Brief Psychiatric Rating Scale baseline total score, 32.2 [5.4]) despite receiving clozapine monotherapy at the highest tolerated dosage. The results obtained evidenced that reboxetine at a dosage of 4 mg/d mildly reduced only depressive symptoms (Calgary Depression Scale for Schizophrenia: P = 0.035, Cohen d = 0.7), whereas worsening of performances on phonemic fluency (P = 0.012, Cohen d = 0.5) was observed. After Bonferroni correction, changes at the Calgary Depression Scale for Schizophrenia and at the Verbal Fluency Task were not further confirmed.The results obtained indicate that reboxetine seemed to be scarcely effective for reducing clinical symptoms in patients with schizophrenia who have had an incomplete clinical response to clozapine. Regarding cognitive functioning, in our sample, a trend to experience cognitive impairment in the examined domains was observed, as confirmed by a mild worsening of performances on cognitive tasks.Schizophrenia is a heterogeneous disorder with regard to pathophysiology; therefore, data reflecting the mean response of a sample of patients may fail to reveal therapeutic effects. More research is needed to better identify subgroups of patients with peculiar features, which may account for responsivity to experimental medications and augmentation strategies.
authors.affiliation: From the Departments of *Neurosciences and †Clinical and Experimental Medicine and Pharmacology, University of Messina, Messina; and ‡Department of Health Sciences, University "Magna Graecia," Catanzaro, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bruno
authors.forename: Rocco
authors.initials: R
authors.lastname: Zoccali
authors.forename: Paolo Micali
authors.initials: PM
authors.lastname: Bellinghieri
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pandolfo
authors.forename: Pasquale
authors.initials: P
authors.lastname: De Fazio
authors.forename: Edoardo
authors.initials: E
authors.lastname: Spina
authors.forename: Maria Rosaria A
authors.initials: MR
authors.lastname: Muscatello
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D003024:Clozapine / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000139:chemically induced; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D009025:Morpholines / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D000077593:Reboxetine; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D009025:Morpholines; D000077593:Reboxetine; D003024:Clozapine