No effects of antidepressants on negative symptoms in schizophrenia
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No effects of antidepressants on negative symptoms in schizophrenia. / Hinkelmann, Kim; Yassouridis, Alexander; Kellner, Michael; Jahn, Holger; Wiedemann, Klaus; Raedler, Thomas J.
in: J CLIN PSYCHOPHARM, Jahrgang 33, Nr. 5, 01.10.2013, S. 686-90.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - No effects of antidepressants on negative symptoms in schizophrenia
AU - Hinkelmann, Kim
AU - Yassouridis, Alexander
AU - Kellner, Michael
AU - Jahn, Holger
AU - Wiedemann, Klaus
AU - Raedler, Thomas J
PY - 2013/10/1
Y1 - 2013/10/1
N2 - Negative symptoms are common in schizophrenia, but often difficult to differentiate from depression. They are associated with long-term impairment and do not respond well to current treatment approaches. Even though antidepressants are commonly prescribed in schizophrenia, their beneficial effect is still under debate. In the present study, we aimed to investigate the effect of serotonergic versus noradrenergic antidepressant add-on therapy on negative symptoms in schizophrenia. Fifty-eight patients with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and with predominant negative symptoms were randomized in a double-blind design to add-on treatment with citalopram, reboxetine, or placebo for 4 weeks. Analysis of covariance with repeated-measures design was used to compare improvement between treatment groups in scores of the Positive and Negative Syndrome Scale and the Hamilton Rating Scale for Depression. A χ² test was used to compare responder rates between treatment groups. Repeated-measures analysis of covariance revealed no differences between treatment groups over time (treatment × time, not statistically significant) for Positive and Negative Syndrome Scale subscales. Although a subgroup analysis in subjects fulfilling the criteria for minor depression was suggestive of higher responder rates in the citalopram group compared with reboxetine, the results did not reach significance level. Our findings do not support a beneficial effect of adjunctive antidepressant treatment on negative symptoms in schizophrenia. However, depressive symptoms are reduced in patients with minor depression by citalopram but not reboxetine, which is in line with previous findings.
AB - Negative symptoms are common in schizophrenia, but often difficult to differentiate from depression. They are associated with long-term impairment and do not respond well to current treatment approaches. Even though antidepressants are commonly prescribed in schizophrenia, their beneficial effect is still under debate. In the present study, we aimed to investigate the effect of serotonergic versus noradrenergic antidepressant add-on therapy on negative symptoms in schizophrenia. Fifty-eight patients with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and with predominant negative symptoms were randomized in a double-blind design to add-on treatment with citalopram, reboxetine, or placebo for 4 weeks. Analysis of covariance with repeated-measures design was used to compare improvement between treatment groups in scores of the Positive and Negative Syndrome Scale and the Hamilton Rating Scale for Depression. A χ² test was used to compare responder rates between treatment groups. Repeated-measures analysis of covariance revealed no differences between treatment groups over time (treatment × time, not statistically significant) for Positive and Negative Syndrome Scale subscales. Although a subgroup analysis in subjects fulfilling the criteria for minor depression was suggestive of higher responder rates in the citalopram group compared with reboxetine, the results did not reach significance level. Our findings do not support a beneficial effect of adjunctive antidepressant treatment on negative symptoms in schizophrenia. However, depressive symptoms are reduced in patients with minor depression by citalopram but not reboxetine, which is in line with previous findings.
KW - Adrenergic Uptake Inhibitors
KW - Adult
KW - Affect
KW - Analysis of Variance
KW - Antidepressive Agents
KW - Antipsychotic Agents
KW - Chi-Square Distribution
KW - Citalopram
KW - Double-Blind Method
KW - Drug Therapy, Combination
KW - Female
KW - Germany
KW - Humans
KW - Male
KW - Middle Aged
KW - Morpholines
KW - Psychiatric Status Rating Scales
KW - Schizophrenia
KW - Schizophrenic Psychology
KW - Serotonin Uptake Inhibitors
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1097/JCP.0b013e3182971e68
DO - 10.1097/JCP.0b013e3182971e68
M3 - SCORING: Journal article
C2 - 23857309
VL - 33
SP - 686
EP - 690
JO - J CLIN PSYCHOPHARM
JF - J CLIN PSYCHOPHARM
SN - 0271-0749
IS - 5
ER -