Adjunctive Antidepressants May Offer Benefits for People With Schizophrenia

Antidepressants added to antipsychotic medications for patients with schizophrenia and depressive symptoms are likely safe and effective, suggest results from a systematic review and meta-analysis published online in the American Journal of Psychiatry.

“Analysis of primary outcomes (depressive and negative symptoms) suggests small, beneficial effects of adjunctive antidepressants. It would appear that this augmentation can be accomplished with a low risk of exacerbation of psychosis and adverse effects,” researchers wrote. “However, secondary and subgroup analyses should be interpreted cautiously and considered exploratory.”

The meta-analysis spanned 82 randomized controlled trials that included a total of 3,608 patients with schizophrenia and depression.

Compared with placebo or no treatment for depressive symptoms, add-on antidepressants appeared more effective for depressive symptoms, negative symptoms, overall symptoms, positive symptoms, quality of life, and responder rate, researchers reported. In studies with minimum thresholds of depressive and negative symptoms required for inclusion, the effects of antidepressants were more pronounced.

Researchers found no significant differences between add-on antidepressants compared with placebo or no treatment in psychosis exacerbation, premature discontinuation, and the number of participants who experienced at least 1 adverse event.

On the other hand, patients taking add-on antidepressants were more likely to report abdominal pain, constipation, dizziness, and dry mouth, researchers reported.  

—Jolynn Tumolo

Reference:

Helfer B, Samara MT, Huhn M, et al. Efficacy and safety of antidepressants added to antipsychotics for schizophrenia: a systematic review and meta-analysis. The American Journal of Psychiatry. 2016 June 10;[Epub ahead of print].