The Role of Selegiline in the Treatment of Negative Symptoms Associated with Schizophrenia

• Published in: The Annals of pharmacotherapy 2007-05, Vol.41 (5), p.851-856
• Main Authors: Fohey, Krista D, Hieber, Robin, Nelson, Leigh Anne
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Biological and medical sciences; Dopamine Agents - therapeutic use; Humans; Medical sciences; Monoamine Oxidase Inhibitors - therapeutic use; Pharmacology. Drug treatments; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Schizophrenia; Schizophrenia - drug therapy; Selegiline - therapeutic use
• ISSN: 1060-0280; 1542-6270
• DOI: 10.1345/aph.1H556

Objective: To evaluate the role of selegiline in the treatment of negative symptoms associated with schizophrenia. Data Sources: MEDLINE (1966–January 2007) and PsychINFO (1967–January 2007) were searched, using the terms schizophrenia, negative symptoms, and selegiline. A bibliographic search was conducted, as well. Study Selection and Data Extraction: All English-language articles identified from the search were evaluated. All primary literature was included in the review. Data Synthesis: Based on its dopamine-enhancing property, selegiline has been studied as augmentation to antipsychotic therapy for the treatment of negative symptoms associated with schizophrenia. The efficacy of low-dose oral selegiline for the treatment of negative symptoms has been evaluated in 1 case report, 2 open-label trials, and 2 controlled trials. The case report and both open-label trials report improvement of negative symptoms associated with low-dose oral selegiline. In 1 of the controlled trials, selegiline showed no difference in effect from that of placebo. These data are limited by small sample sizes. The largest controlled trial demonstrated a statistically significant difference between selegiline and placebo; however, the clinical significance is questionable, given that patients treated with selegiline were still experiencing marked negative symptoms at study completion. No comparative studies evaluating low-dose oral selegiline versus other augmentative treatment options for negative symptoms associated with schizophrenia exist at this time. Conclusions: Given the limitations of current literature, low-dose oral selegiline cannot be recommended for treatment of negative symptoms associated with schizophrenia. Additional controlled trials are needed to better delineate whether there is a role for selegiline in decreasing the burden of negative symptoms associated with schizophrenia.