February 2008

Rimonabant Causes Depression and Anxiety
Rimonabant works as a weight loss agent but may cause depression and anxiety.

Selegiline Augmentation for Negative Symptoms of Schizophrenia
Patients with schizophrenia who take selegiline (Eldepryl, Emsam) in addition to antipsychotic drugs may have greater improvement in negative symptoms.

Managing Psychosis in Parkinson's Disease and DLB
Psychosis in Parkinson’s disease or dementia with Lewy bodies is difficult to treat, and patients are sensitive to side effects of drugs used for these conditions.

New Medicines for GAD: Duloxetine and Quetiapine
Duloxetine (Cymbalta) and quetiapine (Seroquel) are effective in treating generalized anxiety disorder.

In Brief
FDA Warns About Varenicline Psychiatric Adverse Effects; Index Ranks States on Prevalence of Depression and Suicide

Norepinephrine Uptake Inhibition
Atomoxetine (Strattera) inhibits norepinephrine uptake at lower doses than does venlafaxine (Effexor and others) or paroxetine (Paxil and others).

Selegiline Augmentation for Negative Symptoms of Schizophrenia

February 2008

The treatment of patients with schizophrenia typically focuses on controlling florid symptoms, such as hallucinations, delusions, and aggressive behavior. Even with our best treatments, patients seldom recover completely. Negative symptoms of schizophrenia—blunted affect, apathy, impoverished thought and speech, low motivation, social withdrawal—often take the greatest toll on function. To alleviate negative schizophrenia symptoms, many medications have been used to augment antipsychotic drugs. Recently, Amiri and coworkers tried the monoamine oxidase type-B inhibitor selegiline (Eldepryl, Emsam).1

Investigators assigned 11 women and 29 men with chronic schizophrenia to either selegiline, 5 mg bid, or placebo, in addition to risperidone, 6 mg/day, for 8 weeks in a double-blind study. Positive symptoms of schizophrenia responded similarly in both treatment groups, but patients taking selegiline had significantly greater improvement in negative symptoms. There were no significant side effect differences between selegiline and placebo.

The authors acknowledge that these data are preliminary and call for further research to replicate their encouraging results.

1Amiri A, Noorbala AA, Nejatisafa AA, Ghoreishi A, Derakhshan MK, Khodaie-Ardakani MR, Hajiazim M, Raznahan M, Akhondzadeh S: Efficacy of selegiline add on therapy to risperidone in the treatment of the negative symptoms of schizophrenia: A double-blind randomized placebo-controlled study. Hum Psychopharmacol, in press.