Citalopram Augmentation for Subsyndromal Symptoms of Depression in Middle-Aged and Older Outpatients With Schizophrenia and Schizoaffective Disorder

Zisook, Sidney; Kasckow, John; Golshan, Shahrokh; Fellows, Ian E.; Solorzano, Ellen; Lehman, David H.; Mohamed, Somaia; Jeste, Dilip V.

doi:10.4088/jcp.08m04261

Cited by 65 publications

(54 citation statements)

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“…Contrary to our hypothesis, citalopram augmentation to treat SSD among patients with schizophrenia did not yield significant improvements in cognitive function, even though, as described elsewhere [5], citalopram augmentation did result in a significant improvement in depressive and negative symptoms relative to the placebo. The lack of observed cognitive effects of treating SSD in schizophrenia may speak to the general tenacity of cognitive deficits in schizophrenia [1], but may also reflect the relatively moderate-to-mild severity of depressive symptoms in this sample.…”

Section: Discussioncontrasting

confidence: 99%

“…As previously reported [5] we found augmentation of antipsychotic treatment with an antidepressant (citalopram) results in a significant reduction of the severity of subsyndromal depressive symptoms (SSD) among middle-aged and older patients with schizophrenia or schizoaffective disorder. We found no significant effects of citalopram on the Folstien Mini-Mental Status Examinations (MMSE) [6], but the MMSE is a course measure designed to stage the severity of dementia; it may not be sensitive to the less severe cognitive deficits that tend to characterize schizophrenia [1].…”

Section: Introductionsupporting

confidence: 58%

“…The average dose of citalopram given throughout the trial was 28.9 mg (SD = 9.8, range 10–40) per day. The demographic and clinical characteristics among the 2 groups have been reported elsewhere [5], but, as briefly summarized in table 1, other than a higher proportion of widowed patients than the placebo group, there were no significant demographic or clinical differences between groups. As reported previously [5], citalopram augmentation resulted in significantly more improvement in depressive symptoms relative to the changes seen in the placebo group over the 12-week course of the study.…”

Section: Resultsmentioning

confidence: 86%

“…Data were collected as part of an NIMH-funded 12-week double-blind randomized placebo-controlled trial of augmentation of a primary antipsychotic medication with citalopram to decrease depressive symptoms in schizophrenia/schizoaffective disorder and SSD [5]. Participants were recruited through the University of California, San Diego (UCSD) Advanced Center for Innovation in Services and Interventions Research on Late-Life Psychoses and the VA Cincinnati Health Care System, Cincinnati, Ohio.…”

Section: Methodsmentioning

confidence: 99%

“…Between February 2001 and January 2006, 106 participants were recruited from the San Diego site and 92 from the Cincinnati site. For full inclusion and exclusion criteria please refer to Zisook et al [5]. Briefly, the study included people with schizophrenia or schizoaffective disorder and SSD who were aged ≥40 years and who did not have any other Axis I disorder within 2 months of enrollment.…”

Section: Methodsmentioning

confidence: 99%

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Does Antidepressant Treatment Improve Cognition in Older People with Schizophrenia or Schizoaffective Disorder and Comorbid Subsyndromal Depression?

Dawes

Palmer²,

Meeks³

et al. 2012

Neuropsychobiology

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Background: Subsyndromal symptoms of depression (SSD) in patients with schizophrenia are common and clinically important. While treatment of depression in major depressive disorder may partially ameliorate cognitive deficits, the cognitive effects of antidepressant medications in patients with schizophrenia or schizoaffective disorder and SSD are unknown. Methods: The goal of this study was to assess the impact of SSD and their treatment on cognition in participants with schizophrenia or schizoaffective disorder aged ≧40 years. Participants were randomly assigned to a flexible dose treatment with citalopram or placebo augmentation of their current medication for 12 weeks. An ANCOVA compared improvement in the cognitive composite scores, and a linear model determined the moderation of cognition on treatment effects based on the Hamilton Depression Rating Scale and the Calgary Depression Rating Scale scores between treatment groups. Results: There were no differences between the citalopram and placebo groups in changes in cognition. Baseline cognitive status did not moderate antidepressant treatment response. Conclusions: Although there are other cogent reasons why SSD in schizophrenia warrant direct intervention, treatment does not substantially affect the level of cognitive functioning. Given the effects of cognitive deficits associated with schizophrenia on functional disability, there remains an ongoing need to identify effective means of directly ameliorating them.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionsupporting

confidence: 58%

Section: Resultsmentioning

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Does Antidepressant Treatment Improve Cognition in Older People with Schizophrenia or Schizoaffective Disorder and Comorbid Subsyndromal Depression?

Dawes

Palmer²,

Meeks³

et al. 2012

Neuropsychobiology

Self Cite

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Antidepressants for people with both schizophrenia and depression

Whitehead

Moss

Cardno

et al. 2002

Cochrane Database of Systematic Reviews

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Background Depressive symptoms, o en of substantial severity, are found in 50% of newly diagnosed su ers of schizophrenia and 33% of people with chronic schizophrenia who have relapsed. Depression is associated with dysphoria, disability, reduction of motivation to accomplish tasks and the activities of daily living, an increased duration of illness and more frequent relapses. Objectives To determine the clinical e ects of antidepressant medication for the treatment of depression in people who also su er with schizophrenia.

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