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Famotidine Augmentation in Schizophrenia: Hope or Hype?

J Clin Psychiatry 2013;74(9):e855-e858
10.4088/JCP.13f08707

Famotidine is a potent, selective, histamine H2 receptor antagonist used in the treatment of peptic ulcer disease. Famotidine (40–200 mg/d) augmentation of antipsychotic medication in treatment-resistant schizophrenia has been the subject of intermittent study for more than 2 decades. Case reports, open studies, and small randomized controlled trials (RCTs) have documented various improvements in total ratings of psychosis, negative symptoms, general psychopathology, and other measures; adverse effects have been few or none. Despite the modestly encouraging results of a recent, widely publicized RCT, for theoretical reasons as well as for reasons related to the quality of the available literature, it is premature to seriously consider famotidine as a possible antipsychotic augmentation agent. It is particularly noteworthy that, given that the drug was initially studied for possible efficacy against deficit or negative symptoms of schizophrenia, no RCT has established such an efficacy.