The Comparative Effectiveness of Amitriptyline, Perphenazine, and Their Combination in the Treatment of Chronic Psychotic Female Patients

¹ Department of Medical Research, Spring Grove State Hospital, Baltimore 28, Maryland.
² Baltimore, Maryland

Following an initial placebo interval, 108 anergic, psychotic female patients from the continued-care services of a state psychiatric hospital were randomly assigned to one of four double-blind treatments: amitriptyline, perphenazine, amitriptyline-perphenazine (Triavil®), and placebo. Daily dosages for these treatments were 75 mg., 12 mg, 75 mg. combined with 12 mg., and three tablets, respectively, for the first two weeks, after which dosages were doubled and continued for an additional ten weeks. The patients were evaluated on target scales of depression and psychoticism before and at the end of six and 12 weeks of treatment.

At the six-week evaluation, results of analyses of behavioral criteria indicated few differential drug effects. At 12 weeks, significantly differential findings almost exclusively involved ward ratings, which consistently favored combined treatment and perphenazine over amitriptyline and placebo. In all instances of significance combined treatment was invariably better than placebo, and in all but one instance, better than amitriptyline. For a measure of social contact, combined treatment was also significantly better than perphenazine. As the next most effective agent, perphenazine was found to he significantly better than placebo in two instances and better than amitriptyline in one instance.

Treatment side effects were minimal. Those exhibited by amitriptyline and placebo patients were largely effects associated with the withdrawal of tranquilizing medication. With the possible exception of hypotension, the remaining symptoms were regarded as nonspecific in origin. Nine patients were dropped from treatment for clinical reasons. Of these, three amitriptyline and three placebo patients were considered agitated, and one perphenazine and one amitriptyline-perphenazine patient, hypotensive. One additional perphenazine patient was removed from treatment because of nausea and vomiting.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				B. A. Prusoff, D. H. Williams, M. M. Weissman, and B. M. Astrachan Treatment of Secondary Depression in Schizophrenia: A Double-blind, Placebo-Controlled Trial of Amitriptyline Added to Perphenazine Arch Gen Psychiatry, May 1, 1979; 36(5): 569 - 575. [Abstract] [PDF]

				S. G. Siris, D. P. van Kammen, and J. P. Docherty Use of Antidepressant Drugs in Schizophrenia Arch Gen Psychiatry, November 1, 1978; 35(11): 1368 - 1377. [Abstract] [PDF]