Article

Use of antidepressant drugs in schizophrenia

Archives of General Psychiatry (Impact Factor: 14.48). 12/1978; 35(11):1368-77.
Source: PubMed

ABSTRACT

This review surveys the therapeutic efficacy of tricyclic antidepressants and monoamine oxidase inhibitors in schizophrenic patients. In general, the use of these drugs alone was found not to be warranted in schizophrenia, except perhaps in the so-called pseudoneurotic subgroup. In most cases, combinations of antidepressants and phenothiazines were not more beneficial than phenothiazines alone. In particular, the conditions of agitated patients and patients with histories of social deviance dating back to childhood were often made worse by the addition of an antidepressant. However, when the patients who demonstrated symptoms of clinical depression other than anergia were isolated from several of these studies, it was found that they constituted a subgroup that was often benefited by use of these combinations. Favorable and unfavorable clinical response patterns are discussed, and recommendations for future research are outlined.

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    • "Multiple studies and clinical trials have verified the effect of these drugs in weight gain as large as 30–50 pounds after short-term use of Olanzapine [4]. The weight gain adds to the risk of diabetes mellitus and hyperlipidemia [5] [6]. In order to prevent or diminish the induced weight gain caused by Olanzapine, several types of drugs have been investigated including H2-receptor antagonists such as Nizatidine and Ranitidine [7] [8] as well as selective serotonin reuptake inhibitors such as Fluoxetine, topiramate, reboxetine-betahistine, aripiprazole, and Amantadine [9] [10]. "
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    ABSTRACT: Induced weight gain is a disturbing side effect of Olanzapine that affects the quality of life in psychotic patients. The aim of this study was to assess the efficacy of Ranitidine in attenuating or preventing Olanzapine-induced weight gain. A parallel 2-arm clinical trial was done on 52 patients with schizophrenia, schizoaffective and schizophreniform disorders who received Olanzapine for the first time. All these were first-episode admitted patients. They were randomly allocated to receive either Ranitidine or placebo. The trend of body mass index (BMI) was compared between groups over 16-week course of treatment. Mean weight was 62.3 (SD: 9.6) kg at baseline. Thirty-three subjects (63.5%) had positive family history of obesity. The average BMI increment was 1.1 for Ranitidine group and 2.4 for the placebo group. The multivariate analysis showed this effect to be independent of sex, family history of obesity, and baseline BMI value. The longitudinal modeling after controlling for baseline values failed to show the whole trend slope to be different. Although the slight change in trend's slope puts forward a hypothesis that combined use of Ranitidine and Olanzapine may attenuate the weight gain long run, this needs to be retested in future larger scale long-term studies. This trial is registered with IRCT.ir 201009112181N5.
    Full-text · Article · Jul 2013
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    • "No review provides data on demographic or other subgroups of patients who might benefit from adjunctive antidepressant treatment. In an individual study, Siris et al. (1978) explore whether paranoia influences outcome in adjunctive antidepressant use; finding conflicting evidence , they came to no conclusion. ECT. "
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    ABSTRACT: Substantial proportions of patients with schizophrenia do not achieve acceptable levels of response with antipsychotic therapy alone, which commonly leads clinicians to use additional somatic interventions. This article reviews the literature on the use of adjunctive pharmacological treatments and electroconvulsive therapy (ECT) in schizophrenia. The authors find that, despite a large volume of literature, it is difficult to draw conclusions or treatment recommendations from available data because of small sample sizes and widely divergent study designs. At present, there is little firm evidence that adding adjunctive agents to standard neuroleptics will dramatically change the somatic treatment of schizophrenia. The most promising adjunctive agents are benzodiazepines, lithium, and carbamazepine, as well as antidepressants and ECT for affective symptoms. Future inpatient research on adjunctive treatments should be multicenter studies, followed by long-term outpatient trials that assess quality-of-life issues as well as symptom relief.
    Preview · Article · Feb 1995 · Schizophrenia Bulletin
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    • "This outcome, however, may not adequately represent the more common prescribing practice of using an antidepressant adjunctively with a neuroleptic to treat chronically psychotic patients who manifest features of major depression. A review bySiris et al. (1978)of studies up to 1978 in which such patients were treated with combinations of a neuroleptic and an antidepressant concluded that some depressed schizophrenic patients showed improvement in their depressive symptoms. Many of the studies reviewed, however, suffered from methodological problems, such as unclear diagnostic criteria and possibly insufficient doses or duration of trials of antidepressants. "
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    ABSTRACT: Depression in schizophrenic patients is common but often untreated. A review of seven recent studies reveals that tricydic antidepressants (TCAs) can be effective when used in conjunction with neuroleptic medication after the acute psychotic phase has resolved, with only minimal risk of exacerbation of psychotic symptoms. TCAs were not found to be effective against anergy or the “negative symptoms” of schizophrenia, however. The simultaneous use of TCAs and neuroleptics can result in increased blood levels of each, as well as increased risk of anticholinergic side effects. Some promising work in the use of nontricydic anti-depressants in schizophrenia is described.
    Preview · Article · Feb 1991 · Schizophrenia Bulletin
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