S Shoja Shafti, MS Jafarabad and R Azizi,
Therapeutic advances in psychopharmacology, Oct 2015
Negative symptoms are a significant barrier to successful functional outcome and recovery in individuals with schizophrenia and their management is not unproblematic. Reboxetine is a norepinephrine reuptake inhibitor (NRI). Previous studies regarding the useful effects of reboxetine on deficit symptoms of schizophrenia have resulted in inconsistent results. The present study therefore evaluated the effectiveness of reboxetine as an adjunctive treatment in a group of schizophrenic patients with prominent negative symptoms.A total of 50 male inpatients meeting diagnosis of schizophrenia entered into a 12-week parallel group, double-blind study for random assignment to reboxetine (n = 25 patients) or placebo (n = 25 patients). The inclusion criterion, in addition to the diagnosis of schizophrenia, was the existence of obvious negative symptoms for a duration of at least 2 years. The Scale for Assessment of Negative Symptoms (SANS) was used as the primary outcome measure. The Scale for Assessment of Positive Symptoms (SAPS), Simpson Angus Scale (SAS), Hamilton Rating Scale for Depression (HAM-D) and Mini-Mental Status Examination (MMSE) were used for comparison of the intervening parameters in this study.According to the findings, 76% of patients in the target group showed some positive response to reboxetine compared with 24% in the control group (p < 0.01). The mean total score of SANS in the reboxetine group decreased significantly from 79.94 ± 1.20 to 74.23 ± 4.07 (p < 0.0001) at the end of the study; such an improvement was not significant in the placebo group with a decrease from 80.42 ± 2.46 to 79.08 ± 5.83 (p < 0.29). Changes of SAPS were insignificant in both groups. Effect size analysis for changes of SANS at the end of assessment indicated a large improvement with reboxetine (Cohen's d = 2.91).Reboxetine, as an adjuvant to haloperidol, may have a helpful effect on the deficit syndrome of schizophrenia.