The purpose of this review is to analyze approaches to the treatment of depressive and negative disorders in schizophrenia in terms of their level of efficacy and safety. Materials and Methods: A search was conducted for full-text articles published over the last 10 years in PubMed, Springer, Wiley Online Library, Taylor & Francis Online, APA PsycInfo, CORE, Science Direct, and eLIBRARY.RU databases. Several articles published previously to this period were also included into the review due to their high scientific value. Results: Our review suggests that antidepressants (ADs) are effective medications and they can be prescribed to correct depressive disorders and negative symptoms in patients with schizophrenia when used in combination with antipsychotics (АPs). However, when administering ADs and АPs combinations, it is important to consider the safety profile of these combinations as well as their tolerance. Negative symptoms of schizophrenia, including those induced by a number of АP, are less amenable to correction by АDs monotherapy, which requires a long period of АPs (on average - 8 weeks), which can be limited in the real life of the patient outside the hospital. Current approaches to the therapy of depressive disorders in patients suffering from schizophrenia vary from country to country. However, most of АDs used in clinical psychiatric practice are widely used in the comorbid state under consideration. Conclusion: The efficacy and safety of АDs of the different classes considered in this review depends on their mechanisms of action, duration of admission, type of АPs taken, and specific clinical situation (acute depressive disorder, major depressive episode, or chronic depressive episode). Most promising in clinical practice are serotonin–norepinephrine reuptake inhibitors (SNRIs) and dual ADs. The use of tricyclic antidepressants (TCAs) is limited due to a higher risk of adverse drug reactions (ADRs). The use of most selective serotonin reuptake inhibitors (SSRIs) is limited due to the risk of aggravation of hallucinations (this risk being higher for patients with visual hallucinations, and lower for those with auditory hallucinations) and\or iatrogenic psychosis. These ADRs may probably occur in patients suffering from schizophrenia due to their ideal "poor metabolizer" pharmacogenetic profile, since most of the drugs considered in this review have hepatic metabolism.

Objetivos: El trastorno psicótico inducido por cannabis (CIP) es cada vez más frecuente sin embargo no tiene una intervención terapéutica dirigida ni específica. La CIP puede tener una evolución aguda benigna o evolucionar a un trastorno psicótico funcional crónico como la Esquizofrenia (SZE). A pesar de que los estudios en animales proporcionan evidencia de que el cannabis desencadena mecanismos epigenéticos que interfieren con el desarrollo de procesos neurológicos y el uso de cannabis se considera un factor de riesgo para el desarrollo de SZE, la información sobre la epigenética de la psicosis inducida por cannabis es escasa. Este estudio tiene como objetivo evaluar la presencia de mecanismos epigenéticos en genes relacionados con la SZE en pacientes con un trastorno psicótico inducido por cannabis y determinar la estabilidad de los marcadores epigenéticos con el tratamiento habitual frente a la intervención con psicoterapia grupal. Material y métodos: Proponemos un ensayo de diseño mixto que incluirá un grupo de pacientes con Trastorno por Consumo de Cannabis (CUD) y un grupo de pacientes con CUD y CIP. En la línea de base habrá una evaluación inicial con una entrevista clínica extensa para identificar factores ambientales específicos, evaluar síntomas negativos y positivos, estado cognitivo y funcional y consumo de cannabis y con recolección de muestras de sangre para análisis de cambios epigenéticos. Un grupo seleccionado de pacientes se inscribirá en psicoterapia grupal CANDIS. Esto se repetirá a los 12 meses junto con un nuevo análisis epigenético. Resultados y conclusiones: Este estudio nos ayudará a comprender la relación entre el cannabis y la psicosis. Además, esperamos identificar factores de riesgo ambientales y clínicos para el desarrollo de la psicosis con el consumo de cannabis y / o la evolución clínica a un trastorno psicótico crónico, así como, otros fatores para mejorar el tratamiento de estos pacientes.