Antidepressants in Treatment of Schizophrenia

Peter Yellowlees, MBBS, MD


April 13, 2011

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This is the Medscape Psychiatry Minute. I'm Dr. Peter Yellowlees. Negative symptoms seen in patients with chronic schizophrenia are commonly treated with antidepressants in an attempt to reduce disability, but is this an effective clinical strategy? Three investigators[1] from Wolverhampton, England, have performed a systematic review and meta-analysis of randomized controlled trials comparing the effects of antidepressants and placebo on the negative symptoms of chronic schizophrenia measured through standardized rating scales. There were 23 trials involving 5 selective serotonin reuptake inhibitors mirtazapine, reboxetine, mianserin, trazodone, and ritanserin given to 819 patients. The overall mean difference between the treatment and control groups was moderately in favor of antidepressants with significant responses for fluoxetine, trazodone, and ritanserin. The investigators concluded that antidepressants added to antipsychotics are more effective in treating the negative symptoms of schizophrenia than antipsychotics alone. This is important news for all physicians who treat patients with schizophrenia. This article is selected from Medscape Best Evidence. I'm Dr. Peter Yellowlees.