title: Triiodothyronine accelerates and enhances the antipsychotic effect of risperidone in acute schizophrenia.
abstract: In acute psychotic schizophrenia patients we investigated if the combination of triiodothyronine (T3) plus risperidone was more effective when compared to risperidone monotherapy. Thirty-two in-patients meeting the DSM-IV-TR diagnostic criteria for schizophrenia and without thyroid disease received risperidone (flexibly adjusted dose for tolerability) and were randomized to additionally receive either T3 (25 μg daily; risperidone plus T3 group) or placebo (risperidone plus placebo group). Treatment lasted until meeting the response to treatment criteria defined as score of ≤ 3 on the Clinical Global Impression Severity and Improvement scales. Acute psychotic episode symptom severity was evaluated using the Brief Psychiatric Rating Scale (BPRS) at treatment initiation and at the final study assessment. Fourteen patients were randomized to receive risperidone plus T3 and eighteen to receive risperidone plus placebo. The time until treatment response was shorter in the risperidone plus T3 group relative to the risperidone plus placebo group (25.5 ± 4.4 days vs 32.2 ± 8.2 days, respectively; p = 0.001). Moreover, there was a greater reduction of BPRS-total score (p = 0.01) in the risperidone plus T3 group relative to the risperidone plus placebo group. Treatment with T3 was associated with shorter time to treatment response (β = -0.440, p = 0.022) and with greater improvement in BPRS score (β = 0.240, p = 0.053), independent of patients' gender, age, baseline BPRS score and mean risperidone dose. The study confirms that addition of T3 to risperidone was associated with accelerated and enhanced treatment response in acutely psychotic schizophrenic patients.
authors.affiliation: Clinic of Psychiatry, Lithuanian University of Health Sciences, Mickeviciaus str. 9, Kaunas, LT-44307, Lithuania. Electronic address: vsteibliene@gmail.com.
authors.forename: Vesta
authors.initials: V
authors.lastname: Steibliene
authors.affiliation: Laboratory of Clinical Research, Institute of Neurosciences, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, LT-50009, Lithuania. Electronic address: a.bunevicius@yahoo.com.
authors.forename: Adomas
authors.initials: A
authors.lastname: Bunevicius
authors.affiliation: Department of Drug Technology and Social Pharmacy, Lithuanian University of Health Sciences, Mickeviciaus str. 9, LT-44307, Kaunas, Lithuania. Electronic address: arunas.savickas@lsmuni.lt.
authors.forename: Arunas
authors.initials: A
authors.lastname: Savickas
authors.affiliation: Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: ajprange@att.net.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Prange
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 Northwest 14 Street, Suite 1455, Miami, FL, 33136, USA. Electronic address: cnemeroff@med.miami.edu.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Nemeroff
authors.affiliation: Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vyduno str. 4, Palanga, LT-00135, Lithuania.
authors.forename: Robertas
authors.initials: R
authors.lastname: Bunevicius
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004357:Drug Synergism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012189:Retrospective Studies; D018967:Risperidone / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy*; D016037:Single-Blind Method; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D014284:Triiodothyronine; D018967:Risperidone
keywords: Acute psychotic episode; Antipsychotic; Risperidone; Schizophrenia; Treatment response; Triiodothyronine