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How are antidepressants relevant to schizophrenia? 

A supplementary, or adjunctive, treatment is administered in conjunction with a patient’s ongoing antipsychotic therapy. Antidepressants have been proposed as an additional therapy to standard antipsychotic treatments, in an attempt to improve functional outcomes and treat symptoms that are not addressed by the antipsychotic medication alone. Antidepressant medications have been studied as treatments for the symptoms of schizophrenia, particularly negative symptoms, as well as for treating people with co-occurring schizophrenia and depression.

What is the evidence for adjunctive antidepressants?

Moderate to high quality evidence shows a medium effect size favouring selective serotonin re-uptake inhibitors, and moderate quality evidence suggests a small effect favouring noradrenergic and specific serotonergic antidepressants over placebo for improving depression, global cognition, executive functioning and negative symptoms, although these improvements may not be clinically significant. Particular improvement was noted for affective flattening and motivation. There were no differences in side effects, apart from drowsiness/sedation/somnolence levels being higher in those receiving noradrenergic and specific serotonergic antidepressants compared to placebo. Moderate to low quality evidence shows limited benefit of other antidepressants (MAOIs, TCAs) for improving negative symptom severity or aggressive behaviour. Moderate to high quality evidence suggests the atypical antidepressant bupropion may be used for reducing smoking in the short term.

Also see the comorbid depression topic.

August 2016

Page last updated: 2:36  7 September 2017

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