A Clinical Trial of Adjuvant Allopurinol Therapy for Moderately Refractory Schizophrenia
J Clin Psychiatry 2005;66(2):213-219
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To evaluate the xanthine oxidase
inhibitor allopurinol as an adjuvant treatment for patients with
moderately refractory schizophrenia, with the objective of
increasing the endogenous pool of purines, including the
Method: A double-blind, placebo-controlled,
crossover clinical trial of add-on allopurinol (300 mg b.i.d.)
for poorly responsive schizophrenia or schizoaffective disorder
(DSM-IV criteria) was conducted. Thirty-five patients were
enrolled, of whom 22 completed the 12 weeks of the study.
Eighteen of these patients also completed a P50 evoked potential
Results: Allopurinol was well tolerated and
produced significant improvement in Positive and Negative
Syndrome Scale (PANSS) total, positive, negative, and general
scores, particularly for positive symptoms compared with baseline
and with placebo phase. Nine patients improved more than 20% in
PANSS total score during allopurinol treatment, whereas none
responded in the placebo phase. Responders had a shorter duration
of illness than nonresponders. P50 auditory sensory gating failed
to improve with allopurinol treatment.
Conclusions: Allopurinol was an effective and
well-tolerated adjuvant treatment for poorly responsive
schizophrenia, especially for refractory positive symptoms.