Effect of the benzodiazepine derivative estazolam in patients with auditory hallucinations.

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Abstract
The effect of the triazolobenzodiazepine, estazolam, was studied on auditory hallucinations. Patients (28 male, 30 female) with auditory hallucinosis that had responded poorly to neuroleptics alone, were included; most patients were chronic schizophrenics, and most patients were maintained on previous neuroleptic treatment during the trial. Each patient was treated for 3 consecutive 3 wk periods, and randomly allocated to receive estazolam (1 + 1 + 4 mg) either in the 1st and 3rd, or in the 2nd period. Similar-looking placebo tablets were given in the control periods. There were 7 drops-outs, 3 of them due to somnolence on estazolam. In both treatment groups there was a significant (but not significantly different) improvement during the first 3 wk period, with regard to both global clinical state and auditory hallucinations. During the 2nd and 3rd periods, however, the 2 groups differed significantly, in that improvement of global state and hallucinosis was seen on estazolam, and deterioration on placebo. Estazolam (as an addition to neuroleptics) had a significantly better effect than placebo on the global clinical state, on the frequency of, and attitude towards the hallucinations, and also on the single symptoms compulsive thoughts and visual hallucinations (items in the comprehensive Psychopathological Rating Scale). There were few side effects except drowsiness. Possible pharmacokinetic and pharmacodynamic interactions between benzodiazepines and neuroleptics are discussed briefly.