Efficacy and Safety of Antidepressants Added to Antipsychotics for Schizophrenia: A Systematic Review and Meta-Analysis

Helfer, Bartosz; Samara, Myrto; Huhn, Maximilian; Klupp, Elisabeth; Leucht, Claudia; Zhu, Yikang; Engel, Rolf R.; Leucht, Stefan

doi:10.1176/appi.ajp.2016.15081035

Cited by 193 publications

(147 citation statements)

References 64 publications

Supporting

Mentioning

128

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, depressive symptoms correlated with negative symptoms and general adverse events. This may be supported by a recent study on schizophrenia patients, which showed a beneficial effect of adjunctive antidepressants on depressive and negative symptoms (Helfer et al 2015), with a relatively low risk of exacerbation of psychosis and adverse effects (Helfer et al 2015;Mosheva et al 2016).…”

Section: Discussionmentioning

confidence: 70%

Mood Symptoms in Stabilized Patients With Schizophrenia: A Bipolar Type With Predominant Psychotic Features?

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 70%

Mood Symptoms in Stabilized Patients With Schizophrenia: A Bipolar Type With Predominant Psychotic Features?

et al. 2017

View full text Add to dashboard Cite

show abstract

“…ADs were often prescribed for negative and depressive symptoms and cognitive impairment in schizophrenia . Negative and depressive symptoms could be improved in around a third of schizophrenia patients receiving ADs and adjunctive ADs . This may be related to the effect of ADs in modifying serotonergic (5‐HT) dysfunction that is thought to be involved in the pathophysiology of psychotic symptoms …”

Section: Discussionmentioning

confidence: 99%

Concurrent antipsychotic use in older adults treated with antidepressants in Asia

et al. 2019

View full text Add to dashboard Cite

Aim Depressive disorders are common in old age. Antipsychotics (APs) are often used as an adjunctive treatment with antidepressants (ADs) in this population but its patterns of use in Asia are not known. This study explored the rate of combination of APs and ADs in older adult psychiatric patients in Asia. Methods This is a secondary analysis of the database of a multicentre study which recorded participants’ basic demographical and clinical data in standardised format in 10 Asian countries and territories. The data were analysed using univariate and multivariate logistic regression analyses. Results A total of 955 older adult psychiatric in‐ and outpatients were included in this study. The proportion of concurrent AP and AD use was 32.0%, ranging from 23.3% in Korea to 44.0% in Taiwan. Multivariate logistic regression analysis found that younger age, inpatient status and diagnosis of schizophrenia, anxiety and other mental disorders were significantly related to a higher proportion of concurrent use of APs and ADs. Conclusion Around a third of older adult psychiatric patients had concurrent AP and AD use in the Asian countries/regions surveyed. Considering the uncertain effectiveness and questionable safety of the AP and AD combination in this patient population, such should be cautiously used.

show abstract

“…Despite their frequent use on a pragmatic basis, there have been few sufficiently powered, randomized controlled trials of antidepressants for the treatment of depression in schizophrenia, although recent meta-analysis gives some limited evidence of effect. 44 Cognitive behavioral therapy for psychosis (CBTp) has been the subject of much research in recent years, however has primarily focused on effectiveness for positive symptoms, transition from high-risk status and more recently on distress. No CBTp studies have used depression as a primary outcome or target of therapy.…”

Section: Treatment Of Depressionmentioning

confidence: 99%

Depression and Schizophrenia: Cause, Consequence or Trans-diagnostic Issue?

Upthegrove

Marwaha

Birchwood

2016

SCHBUL

262

278

View full text Add to dashboard Cite

The presence of depression in schizophrenia has been a challenge to the Kraepelinian dichotomy, with various attempts to save the fundamental distinction including evoking and refining diagnoses such as schizoaffective disorder. But the tectonic plates are shifting. Here we put forward a summary of recent evidence regarding the prevalence, importance, possible aetiological pathways and treatment challenges that recognizing depression in schizophrenia bring. Taken together we propose that depression is more than comorbidity and that increased effective therapeutic attention to mood symptoms will be needed to improve outcomes and to support prevention.Key words: schizophrenia/depression/aetiology/ transdiagnostic/psychosis Prevalence of Depression in the Life Course of SchizophreniaThe prevalence of depressive disorder in schizophrenia has been reported to be around 40%, however the stage of illness (early vs chronic) and state (acute or post-psychotic) factors influences figures, which can thus vary considerably.1 In acute episodes rates are up to 60%, whilst in post-psychotic schizophrenia rates of moderate to severe depression vary between 20% in chronic schizophrenia and 50% following treatment of first episode.2 When examining very early phases of illness, in groups identified as ultra high risk (UHR) for psychosis, high rates of "comorbid" axis one diagnoses are reported, with over 40% reaching criteria for a depressive disorder, outweighing anxiety or other mood symptoms.3 When depression is investigated longitudinally in schizophrenia, the vast majority, up to 80%, of patients experience a clinically significant depressive episode at 1 or more time point during the early phase. This underlines how cross-sectional rates markedly underestimate the true prevalence and suggests that in the early phase of illness at least, mood symptoms may be more than "comorbid" experiences. The diversity in reported figures for depression is also partly attributed to the challenge in distinguishing mood symptoms from negative symptoms, suggesting a complex and as yet poorly understood overlap with other symptom dimensions at a phenomenological level. 4 Depression in schizophrenia has long been a taxonomic challenge leading to assertions that true schizophrenia is "non-affective"; or invention of new diagnoses and broadening definitions, such as schizoaffective disorder. In DSM-V schizoaffective disorder, the occurrence of the delusions or hallucinations must be present in the absence of any serious mood symptoms for at least 2 weeks whilst the mood disorder must be present for the majority of the total duration of illness.5 Our increasing knowledge as to the prevalence and course of depression in schizophrenia particularly, in the early years makes, the distinction between schizophrenia and new definitions of schizoaffective disorder even more challenging.

show abstract

Efficacy and Safety of Antidepressants Added to Antipsychotics for Schizophrenia: A Systematic Review and Meta-Analysis

Cited by 193 publications

References 64 publications

Mood Symptoms in Stabilized Patients With Schizophrenia: A Bipolar Type With Predominant Psychotic Features?

Mood Symptoms in Stabilized Patients With Schizophrenia: A Bipolar Type With Predominant Psychotic Features?

Concurrent antipsychotic use in older adults treated with antidepressants in Asia

Depression and Schizophrenia: Cause, Consequence or Trans-diagnostic Issue?

Contact Info

Product

Resources

About