Retrospective review of use of adjunctive psychostimulants in patients with schizophrenia

BACKGROUND: Adjunctive psychostimulants have been proposed as a potential treatment option for the management of cognitive and/or negative symptoms of schizophrenia. METHODS: The present study is a retrospective review of use of adjunctive psychostimulants among outpatients enrolled in our tertiary Schizophrenia Program between 2014 and 2019. We assessed response to treatment, adverse effects, and the impact of various clinical factors on treatment outcome. RESULTS: Of the 77 (out of 1,300) participants prescribed psychostimulants during the study period, 42.22% had chart-based evidence of significant improvement, 27.77% had minimal improvement, and 25.55% reported no change. The majority (61.9%) demonstrated improvement in attention, concentration, and/or other cognitive symptoms. Approximately one-third of cases had evidence of emergence of psychosis. Of the factors assessed, comorbid attention-deficit/hyperactivity disorder was associated with an increased likelihood of response, and higher doses of stimulants were associated with likelihood of emergence of psychosis. CONCLUSIONS: Adjunctive psychostimulants could be a potential treatment consideration to address cognitive deficits in selected patients with schizophrenia.