Alprazolam was added, under double-blind conditions, to stable
fluphenazine hydrochloride regimens in 12 symptomatic,
chronically ill inpatients with
schizophrenia. The addition of
alprazolam was associated with significant, albeit modest, reductions in global
psychosis, thought disorder, and
paranoia ratings, with a return to pretreatment levels on discontinuation of
alprazolam treatment. Improvement in "negative symptoms" such as emotional withdrawal paralleled the changes in "positive symptoms" but did not, in itself, reach statistical significance. There were no significant changes in group mean plasma levels of
homovanillic acid or 3-methoxy-4-hydroxyphenylglycol during
alprazolam treatment, although group mean serum
cortisol levels were significantly decreased by
alprazolam treatment. Patients who responded favorably to
alprazolam treatment were significantly more psychotic or anxious before treatment, were older, showed significant
alprazolam-associated reductions in plasma levels of
homovanillic acid, and had significantly more prominent prefrontal cortex
atrophy on computed tomographic scans than patients in whom
alprazolam was without
therapeutic effect. These preliminary data, based on a small sample, suggest that some patients with
schizophrenia who are only partially responsive to standard
neuroleptic treatment may benefit from the addition of triazolobenzodiazepines, such as
alprazolam.