The Causality of Depression in Schizophrenia

Abstract

The phenomenon of post-treatment depression in schizophrenia has become the subject of considerable controversy regarding its causality (Ananth and Chadirian, 1980; McGlashan and Carpenter, 1976a). But as the recent commentary by Hirsch (1982) emphasizes, the most controversial issue is focused on whether this depression is neuroleptic-induced. Hirsch himself refutes neuroleptic-induction on the basis of various uncontrolled data which seem ostensibly incompatible with this causality. Results indicating that pretreatment depressions appear in a high proportion of recently hospitalized schizophrenics, occur in drug-free patients, and frequently remit or decrease following neuroleptic therapy are cited as evidence contradicting neuroleptic-induction. Hirsch therefore proposes an alternative view: that this post-treatment depression is an integral, “revealed” aspect of the schizophrenia syndrome which arises from the same pathophysiological process (cf. McGlashan and Carpenter, 1976b).

Antidepressive therapy in depressed clinical suicides

“…thioridazine, may have antidepressive effects (32); on the other, neuroleptics have been accused of causing depression (33). There is no doubt that the issue of pharmacogenic neuroleptic-induced depression currently remains controversial (34). Neuroleptics, nevertheless, cannot be considered to be highly satisfactory antidepressants and certainly not the medication of choice in the treatment of depressed patients.…”

Depression in Schizophrenia: Perspective in the Era of “Atypical” Antipsychotic Agents

“…Therefore, dopamine blockade by a neuroleptic drug could theoretically lead to anhedonia and, perhaps, depression. Indeed, a state of dysphoria is commonly described by neuroleptic-treated patients (34), a number of older anecdotal reports have suggested a link between neuroleptic use and depression (35)(36)(37)(38)(39), and one study found more anhedonia and depression in maintenance-phase schizophrenic patients who were taking neuroleptics than in others who were not (33). Another study found a positive relationship between haloperidol plasma levels and depressive symptoms in the context of a positive association between extrapyramidal symptoms and depressive symptoms (40), and impairments of quality of life related to neuroleptic-induced dysphoria have been reported (41).…”

Study of Depression in Schizophrenia

“…According to Galdi, (14) depressive symptoms are due to the neuroleptic medication. The finding in my study are opposite to that.…”