***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 19.552 R.P. is 2-Dimethylsulphamoyl-10 - 3(4(2-palmitoyloxyethyl ) piperidino-(1 ) ) propyl phenothiazine . It is the palmitic ester of 19.366 R.P. with rhe proposed generic name of pipotiazine . The substances were developed by the Rh6ne-Poulenc laboratories .  Pipotiazine has neuroleptic properties , pharmacological studies and clinical trials indicating an effect in many ways resembling that of thioproperazine . The palmitic ester was developed in a search for a suitable depot preparation with a long duration of action . Pilot trials indicated a potent neuroleptic effect and marked depot properties . The pilot trials suggested that it might be sufficient to give injections of 19.552 R.P. at intervals of 4 weeks . A depot preparation with such a duration of action would have important advantages in the long-term treatment of chronic psychoses . I t could provide a very suitable pivot around which the necessary after-care of discharged patients could be organized , and in the hospital it could represent an effective and convenient way of administering the necessary neuroleptic treatment . With this background it w-as decided to try 19.552 R.P. in Opd01 Sykehus , a regional mental hospital in Norway . The trial aim ed to answer the following questions 1 . Twenty-one schizophrenic or schizoaffective patients with histories of cannabis abuse and operationally-defined syndromes of post-psychotic depression completed a double-blind trial of adjunctive imipramine added to their on-going medication regimen of fluphenazine decanoate and benztropine . 2 . The imipramine-treated patients had superior global outcome . 3 . Subscales suggested that specific improvement occurred in imipramine-treated patients in the domain of depression-like features . 4 . Psychotic symptomatology was not found to be exacerbated by the imipramine Undertaken in the context of a controlled drug trial involving newly admitted psychiatric hospital patients , this study compared the effectiveness of a " Doctor 's Choice " ( DC ) method of administering psychotropic drugs versus an experimentally determined treatment regimen employing r and om assignment and double-bline procedures . The 32-day drug trial sought to determine the comparative effectiveness of thioridazine-placebo , thioridazine-chlordiazepoxide , and thioridazine-imipramine , with the daily dosage of openly administered thioridazine ranging from 100 to 900 mg and dosages for chlordiazepoxide and imipramine , administered in a double-blind fashion , fixed at daily dosages of 30 and 75 mg , respectively . DC medication , consisting of a choice ( by a research physician ) of any of the three experimental medications determined on the basis of judged clinical need , was added as a fourth treatment category for present purpose s. Criteria of effectiveness included st and arized psychiatric rating scales and global measures of imporvement completed by research team members and ward physicians . Outcome results for the DC group compared to those for a single control group made up of individuals matched with DC patients on the basis of drug assignment indicated an essentially similar clinical effectiveness under both DC and control treatment conditions . Generalization of the finding was limited by the fact that the main treatment effect , attributable to thioridazine , overshadowed the more subtle action of the ancillary drugs Two drug trials in schizoaffective patients are reported . Nineteen " schizomanic " patients were treated for one month , on a double blind basis , with chlorpromazine or lithium and 41 " schizodepressive " patients with amitriptyline , chlorpromazine or both . In the schizodepressive patients there was a trend to a better response to chlorpromazine , but drug response generally was poor , only 20 per cent of patients recovering within the month . In the schizomanic patients lithium seemed as effective as chlorpromazine , which supports the view that these patients were suffering from a variant of mania BACKGROUND Schizophrenic patients have high rates of cigarette smoking compared with the general population . We compared sustained-release ( SR ) bupropion with placebo for smoking cessation in patients with schizophrenic disorders . We also examined how antipsychotic class predicts smoking cessation outcomes with bupropion . METHODS Thirty-two subjects meeting DSM-IV criteria for schizophrenia or schizoaffective disorder and nicotine dependence were r and omized to bupropion SR ( BUP , 300 mg/day ) or placebo ( PLA ) . Outcomes included treatment retention , smoking abstinence rates , expired breath carbon monoxide ( CO ) levels , psychotic symptoms , and medication side effects . RESULTS Bupropion significantly increased trial endpoint 7-day point prevalence smoking abstinence rates compared with placebo [ BUP , 8/16 ( 50.0 % ) , PLA , 2/16 ( 12.5 % ) ; chi(2 ) = 5.24 , df = 1 , p < .05 ] , and reduced CO levels during the trial [ Medication x Time interaction ; Z = 3.09 , p < .01 ] . Positive schizophrenia symptoms were not altered by BUP , but negative symptoms were significantly reduced . Atypical antipsychotic drug treatment enhanced smoking cessation responses to BUP . Major side effects were dry mouth , gastrointestinal symptoms , headache , and insomnia . CONCLUSIONS Our results suggest that 1 ) BUP enhances smoking abstinence rates compared with PLA in nicotine-dependent schizophrenic smokers ; 2 ) BUP is well-tolerated and safe for use in these patients ; and 3 ) atypical antipsychotics may enhance smoking cessation outcomes with BUP The relative efficacy of 4 tranquilizers was investigated in 66 chronic schizophrenics who had been hospitalized for 10.01 years ( mean ) . The role of adding an anti-depressant was also studied . Following a 4 week placebo period , high dosage tranquilizers were given for 16 weeks and amitriptyline was added for the following 16 weeks . Statistical analyses of the various change measures revealed that patients worsened significantly on placebo , all 4 tranquilizers were significantly better than placebo for symptom reduction and maximum improvement was attained within 16 weeks of tranquilizer administration . No significant differences in efficacy were observed among the 4 tranquilizers and addition of amitriptyline did not confer any additional therapeutic advantage The negative symptoms of schizophrenia remain a major clinical challenge . Reboxetine is an antidepressant whose major mechanism of action is as a noradrenergic reuptake inhibitor . This study was a 6-week r and omized placebo-controlled trial of reboxetine or placebo add on to haloperidol 5 mg in the treatment of 30 patients with DSM-IV schizophrenia . The trial failed to demonstrate any significant difference between the placebo and reboxetine groups on any of the outcome measures . This trial does not suggest that increased noradreneregic drive mediated by reuptake inhibition in patients taking dopamine antagonists is of therapeutic value in schizophrenia The beneficial effect of atypical antipsychotic drugs ( APDs ) in treatment-resistant schizophrenia patients has been attributed , mostly , to their relatively high serotonergic (5-HT)2 to dopaminergic (D)2 receptor blockade ratio . We hypothesized that a combination of typical APDs ( D2 antagonists ) and mianserin , a potent 5-HT2 antagonist , might also exert superior efficacy in this population . Eighteen in patients with treatment-resistant schizophrenia who had an acute psychotic exacerbation of the disorder received , in a double-blind design , 30 mg/day mianserin ( n = 9 ) or placebo ( n = 9 ) in conjunction with typical neuroleptics [ haloperidol ( n = 9 ) or perphenazine ( n = 9 ) ] . Clinical status was evaluated before , during , and at the end of 6 weeks of combined treatment with the Brief Psychiatric Rating Scale ( BPRS ) , Scale for the Assessment of Positive Symptoms ( SAPS ) , Scale for the Assessment of Negative Symptoms and Hamilton Rating Scale for Depression . The typical APD/mianserin group exhibited significantly greater improvement in total BPRS scores ( 17.6 % versus 5.5%;P = 0.03 ) and a trend towards greater improvement in SAPS scores ( 35.3 % versus 13.0%;P = 0.07 ) . Our study indicates that patients with chronic treatment-resistant schizophrenia who have an acute psychotic exacerbation ( ‘ acute-on-chronic ’ ) may benefit from the addition of a potent 5-HT2 blocker , such as mianserin , to typical antipsychotics . Our findings may further emphasize the contribution of enhanced 5-HT2 blockade to the ‘ atypicality ’ of the atypical APDs and to their greater efficacy in alleviating symptoms of chronic treatment-resistant schizophrenia & NA ; The efficacy and safety of adding fluvoxamine to antipsychotic treatment in schizophrenic patients with mixed positive and negative symptoms was examined . Fifty‐three patients selected for persistent negative and positive symptoms who were receiving antipsychotic treatment were r and omly allocated to additional fluvoxamine ( 50‐100 mg / day ) or placebo in a double‐blind manner . Fluvoxamine was associated with significant improvement in negative symptoms ( Scale for the Assessment of Negative Symptoms ) compared to placebo . The combination was well tolerated .  Fluvoxamine augmentation  of antipsychotics is safe in chronic schizophrenic patients with mixed positive and negative symptoms  and may ameliorate negative symptoms in such patients Following a 2-week placebo lead-in , schizophrenic patients were r and omly assigned to fluoxetine 20 mg/day or placebo added to depot neuroleptic for a 6-week , double blind trial . All patients had received a stable dose of depot neuroleptic for at least 6 months and did not meet criteria for depression . Serum sample s were obtained at baseline and at weeks 4 and 6 . Scores on the negative symptom subscale of the Brief Psychiatric Rating Scale ( BPRS ) were significantly lower at week 6 , controlling for baseline scores , in patients receiving fluoxetine ( n=20 ) compared to patients receiving placebo ( n=21 ) . Measures of psychosis , depression , global functioning and extrapyramidal symptoms ( EPS ) did not differ between groups at week 6 . Fluoxetine administration was associated with a mean 65 % increase in serum fluphenazine concentrations in 15 patients and a mean 20 % increase in serum haloperidol concentrations in three patients . The change in negative symptoms at week 6 did not correlate with serum concentrations of fluoxetine or norfluoxetine , but did inversely correlate withS-norfluoxetine , an active stereoisomer of fluoxetine . For these chronically ill patients , fluoxetine significantly improved negative symptoms and did not worsen EPS , despite causing substantial elevation in serum concentrations of neuroleptics Four patients with chronic schizophrenia were treated with a combination of fluvoxamine , haloperidol , and benztropine . The combination significantly impaired performance on tests of delayed recall memory and attentional function . Haloperidol concentrations in serum were monitored in three patients and were robustly elevated by fluvoxamine Forty-six schizophrenic or schizoaffective patients with operationally defined episodes of postpsychotic depression were assessed for previous histories of substance abuse . Thirty-five percent had histories of previous cannabis ( marijuana ) abuse . Additionally , 13 % had also abused cocaine , 13 % amphetamines , 11 % hallucinogens , 4 % sedatives , and 2 % opiates . Patients with histories of substance abuse were younger and showed higher index ratings on a subscale of endogenous depressive features . These findings are considered in the context of a possible self-medication hypothesis of substance abuse . A history of substance abuse did not appear to be a contraindication to a therapeutic trial of adjunctive imipramine ( Ciba Geigy Corp. , Summit , NJ ) for postpsychotic depression Eighty-seven predominantly withdrawn chronic male schizophrenics were r and omly assigned to one of three treatment groups . After a two-week course of placebo administration treatment was started with matching tablets containing either amitriptyline 25 mg.+perphenazine 4 mg . , perphenazine 4 mg . , or placebo . For the first five weeks of the trial the dose was one tablet t.i.d . , and for the second five weeks , 2 tablets t.i.d . Neither the nursing staff nor the doctors concerned knew which tablets were which . Wing Scale Form A ( completed by two psychiatrists independently ) and Form B ( filled in by a senior nurse ) yielded very similar results , rating the effectiveness of the three treatments as amitriptyline/perphenazine > perphenazine > Analysis of variance of overall improvement and of individual symptoms revealed that differences between doctors ' assessment s were insignificant . Patients taking amitriptyline/perphenazine showed a significant weight gain . Regular blood examination revealed no abnormalities . The withdrawn , inert hospitalized male schizophrenic constitutes a difficult problem to many workers in the psychiatric field . The encouraging fact emerged from this clinical trial that symptoms such as flattening and incongruity of affect , sometimes made worse by long-term administration of tranquilizing drugs , 
    Output:
    
The combination of antipsychotics and antidepressants may be effective in treating negative symptoms of schizophrenia , but the amount of information is currently too limited to allow any firm conclusions .