Adjuvant role of testosterone in treatment of schizophrenia and its interaction with combination of first and second generation anti-psychotics, chlorpromazine and risperidone

Authors

  • Tarun Vijaywargia Department of Pharmacology, Jhalawar Medical College and Associated group of Hospitals, Jhalawar, Rajasthan, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20182422

Keywords:

Chlorpromazine, Risperidone, Schizophrenia, Testosterone

Abstract

Background: There is great controversy about role of male sex steroid, testosterone, in mental disorders like schizophrenia. This study assessed the effectiveness of testosterone in schizophrenic patients and probes how it modulates the action of combination of first and second generation anti-psychotic medications (Chlorpromazine + Risperidone) both of which are very commonly used anti-psychotic agents in clinical psychiatric practice.

Methods: It Is randomized, double-blind, Clinical study performed in Indian schizophrenic patients (new cases) in the Department of psychiatry from Feb 2003 to March 2004. Patients twelve (12) patients aged 20 to 60 years diagnosed schizophrenics according to ICD-10 Criteria who visited in outpatient department of psychiatry during study period. 12 Patient was treated with combination of oral Chlorpromazine 200mg BD + oral Risperidone 2mg BD, half of the 12 patients also received single dose of testosterone 100mg intramuscularly with above-mentioned treatment. Measure How symptomatology in schizophrenic patients affected is measured by applying various validated psychiatric scales like Brief psychiatric Rating Score (BPRS), Scale for assessment of positive symptom(SAPS), and Scale for Assessment of Negative Symptoms (SANS).

Results: Single dose of Testosterone 100mg administered initially by I.M. route potentiated the reduction level in negative symptoms of schizophrenia by 119% in patients receiving oral Chlorpromazine 200mg along with oral Risperidone 4mg/day.

Conclusions: In this study, Testosterone potentiated the effects of combination of oral Chlorpromazine 100mg BD + Risperidone 2mg BD, on general psychotic manifestations, positive symptoms and negative symptoms of schizophrenia, assessed on BPRS, SAPS and SANS scoring scales, however the effect is most pronounced in negative symptomology of schizophrenia.

References

American psychiatric association. Diagnostic and statistical manual of mental disorders, 4th edition.’ Text revision. Washington, DC, American psychiatric association. 2000.

Zimmerman M, Mattia JI. Psychiatric diagnosis in clinical practice: is comorbidity being missed? Compr Psychiatry. 1999;40:182.

Grover S, Avasthi A, Chakrabarti S, Bhansali A, Kulhara P. Cost of care of schizophrenia: a study of Indian out-patient attenders. Acta Psychiatr Scand. 2005;112:54-63.

Kahn RS, Devis KL. New developments in dopamine and schizophrenia. In Psychopharmacology: The fourth generation of progress (ed.) F.E. Bloom and DJ Kupter. Raven Press, New York; 1995:1193-1204.

Coyle JT, Tsai G, Goff D. Converging evidence of NMDA receptor hypofunction in the Pathophysiology of schizophrenia. Ann J Y Acad Sci. 2003;1003:318.

Griffin JE, Ojeda SR. Text book of Endocrine Physiology, New York, Oxford University Press; 1996;1017-1018.

Shores TJ, Miesegaes G. Testosterone in utero and at birth dictates how stressful experience will affect learning in adulthood. Proc Natl Acad Sci USA .2002 Oct 15;99(21):13955-60.

Bart JM, Van Uljmen H, Belindra HOF, Marc J, Mol TM, Hans Van der Boom, et al, effect of androgens on growth of right and left cerebral hemispheres and also growth of brain cells primarily used in thinking, behavioral and neuron. Biology. 1988;49:344.

Pope HG Jr, Katz DL. psychiatric and medical effects of anabolic-androgenic steroid use. Arch Gen Psychiatry. 1994;51:375.

Kulkarni J, Riedel A, de Castella AR, Fitzgerald PB, Ralfe TJ, Taffe J, et al. A clinical trial of adjunctive estrogen treatment in women with schizophrenia. Arch Women Ment Health. Nov 2002;5(3):99-104.

Decastella A, Granger ABDA. The effect of schizophrenia on sex hormones blood levels. Psychiatric Services. 2002;53:600-3.

Eto K, Kimura H. The production of hydrogen sulfide is regulated by testosterone and S-Adenosyl-L-methionine in mouse brain. J Neurochem. 2002 Oct;83(1):80-6.

Strauss EB, Sands DE, Robinson AM, Tindall WJ, Stevenson WAH. British Medical Journal 08/1952; 2(4775):64-6. Source: PubMed.

Goldstein JM, Link BG. Gender and the expression of schizophrenia. J Psychiatry Res. 1988;22:141-55.

Lewine R. Schizophrenia: an amotivational syndrome in men. Can J Psychiatry. 1985;30:316-8.

Ko YH, Lew YM, Jung SW, Joe SH, Lee CH, Jung HG, et al. Short-term testosterone augmentation in male schizophrenics: a randomized, double-blind, placebo-controlled trial, J Clin Psychopharmacol. 2008 Aug;28(4):375-83.

Malone DA Jr. Pharmacological therapies of anabolic androgenic steroid addiction. In: Miller NS, Gold MS, editors. Pharmacological Therapies for Drug and Alcohol Addictions. New York: Marcel Dekker Inc; 1995:227-237.

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Published

2018-06-22

How to Cite

Vijaywargia, T. (2018). Adjuvant role of testosterone in treatment of schizophrenia and its interaction with combination of first and second generation anti-psychotics, chlorpromazine and risperidone. International Journal of Basic & Clinical Pharmacology, 7(7), 1247–1252. https://doi.org/10.18203/2319-2003.ijbcp20182422

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Section

Original Research Articles