A double-blind, placebo-controlled trial of sertraline for depressive symptoms in patients with stable, chronic schizophrenia

Abstract

There have been no studies specifically examining the efficacy of selective serotonin reuptake inhibitor antidepressants for the symptoms of depression in schizophrenia. This study aimed to determine the efficacy and safety of sertraline as a treatment for depressive symptoms in patients with stable, chronic schizophrenia. The Beck Depression Inventory (BDI) was used as the principal outcome measure and other measures of depressive symptoms as secondary outcome measures. Twenty-six patients were entered into a double-blind, placebo-controlled, 8-week trial of sertraline and were included in the intent-to-treat (ITT) analysis (13 in each group). Eight patients in the sertraline group and 12 in the placebo group completed at least four weeks in the study and were considered to have had adequate treatment. On the ITT analysis, the mean score on the BDI fell 14.5% for the sertraline group and 5.6% for the placebo group (p > 0.05); the mean score on the Hamilton Depression Rating Scale (HDRS) fell 16.99% for the sertraline group and 8.3% for the placebo group (p > 0.05). When the analysis was repeated for those who had received adequate treatment, the mean BDI score fell by 28% for the sertraline group and 6% for the placebo group (p = 0.1); the mean HDRS score fell 31% for the sertraline group and 8.6% for the placebo group (p = 0.02). On the Clinical Global Impression-Improvement Scale, 10 of the 13 patients on sertraline improved against four of the 13 in the placebo group (p = 0.05). Sertraline-treated patients showed a significant improvement on the anxiety/ depression subscale of the BPRS on ITT analysis (F = 10.1, p = 0.004). There was no significant effect on negative or positive symptoms. Sertraline was well tolerated. The results suggest that sertraline is useful as a treatment for depressive symptoms in schizophrenia.

Survey on schizophrenia treatment in Mexico: perception and antipsychotic prescription patterns

“…The antidepressants are frequently prescribed for comorbid depression. Sertraline, a SSRI, has shown efficacy for the treatment of major depression in schizophrenic patients [50,51]. On the other hand, benzodiazepines are first line drugs for the management of agitation or aggression in psychotic patients [5].…”

The rationale for antidepressants in the treatment of schizophrenia: A modern view on the problem in the context of evidence-based medicine

“…Длитель-Доза 2003 [80] 2012 [81] 2000 [82] 2005 [83] 2010 [84] 9 Еще один парадоксальный результат этого ис-следования турецких психиатров заключается в том, что при лечении сертралином (50 мг/сут) состояние больных улучшалось быстрее, чем при применении имипрамина (150 мг/сут). 10 Считается, что использование этой шкалы поз-воляет отграничить депрессивную симптомати-ку от иных расстройств, имитирующих ее (нега-тивные симптомы, психические проявления нейролептического синдрома).…”

“…Хотя некото-рые авторы делают строгий вывод об ослаблении тяжести де-прессии, полученные данные все же свидетельствуют о «скромности» терапевтического эффекта. Например, после окончания одного исследования снижение среднего балла по шкале депрессии Гамильтона в среднем составило всего 16,9%, а по опроснику депрессии Бэка -14,5% [80]. Однако хорошо известно, что для констатации достаточной выра-женности терапевтического эффекта снижение среднего балла по шкалам оценки тяжести депрессии должно состав-лять хотя бы 50%.…”

Mirtazapine add‐on therapy in the treatment of schizophrenia with atypical antipsychotics: a double‐blind, randomised, placebo‐controlled clinical trial

“…Lee et al (1998) found that sertraline was not different to placebo in haloperidol treated patients with schizophrenia (N ¼ 36) for change in Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) Scale scores. However in a similar trial (N ¼ 28) by Mulholland et al (2003) sertraline was superior to placebo for improvement in Beck Depression Inventory (BDI), HAMD and CGI scores. Salokangas et al (1996) found no difference between adjunctive citalopram or placebo with neuroleptic treatment (N ¼ 90) for change in PANSS scores, although the citalopram treated patients reported improved subjective well-being.…”