File Name: antidepressant and schizophrenia and .zip
Am J Psychiatry Jun
Haloperidol and benztropine treatment was continued, while those patients who consistently scored greater than 17 on the Hamilton Rating Scale for Depression were randomly assigned to the following double-blind treatment groups for 4 weeks: adjunctive amitriptyline hydrochloride, desipramine hydrochloride, or placebo. Adjunctive desipramine or amitriptyline showed no significant therapeutic advantage, when compared with haloperidol and placebo, on the Brief Psychiatric Rating Scale or the Hamilton Rating Scale for Depression. After 4 weeks of combined therapy, patients receiving adjunctive amitriptyline or desipramine, as compared with those receiving adjunctive placebo, tended to score higher on the Brief Psychiatric Rating Scale hallucinatory behavior item and on the thinking disturbance factor than patients receiving placebo. These results suggest that adjunctive antidepressants are not indicated for the treatment of depressive symptoms in actively psychotic schizophrenic inpatients.
Am J Psychiatry Jun High-quality evidence supports antidepressant—antipsychotic combinations, and perhaps particularly for patients with marked depressive or negative symptoms.
In individual studies, adding antidepressants to antipsychotics benefited these patients, but changes in practice often require more substantial evidence. Compared with controls, antidepressants did not exacerbate psychosis or increase premature discontinuation due to ineffectiveness or adverse effects. Effect sizes for adjunctive treatment showed a trend to be larger for subpopulations with more pronounced depressive symptoms, postpsychotic depression, and negative symptoms. No differences were found in analyses of individual antidepressants, although several monoamine oxidase inhibitors as a group, amitriptyline, duloxetine, sertraline, and trazodone seemed individually better than controls.
Selective serotonin reuptake inhibitors particularly citalopram and fluvoxamine appeared to improve negative symptoms. With limited data on individual antidepressants, few recommendations can be offered on how to select the best medication for specific clinical scenarios. Nevertheless, high-quality evidence was sufficient to support the authors' conclusions that adding antidepressants to antipsychotics is safe and effective.
Future studies should consider effects of administering antidepressants at different points during the course of illness e. Clinicians should consider adding antidepressants to antipsychotics routinely for patients with schizophrenia, particularly for those with marked depressive or negative symptoms.
Helfer B et al. Efficacy and safety of antidepressants added to antipsychotics for schizophrenia: A systematic review and meta-analysis. Am J Psychiatry Jun 10; [e-pub]. Am J Psychiatry Jun 10 High-quality evidence supports antidepressant—antipsychotic combinations, and perhaps particularly for patients with marked depressive or negative symptoms.
Comment With limited data on individual antidepressants, few recommendations can be offered on how to select the best medication for specific clinical scenarios. Citation s : Helfer B et al.
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Jump to navigation. Depression is common in people with schizophrenia and is associated with substantial problems including an increased risk of suicide. Many clinicians use antidepressant drugs in addition to anti-psychotics in order to treat depression. This review identified eleven randomised controlled trials that compared antidepressants with a placebo in people with schizophrenia who also had depression. There was some evidence that antidepressants did lead to an improvement in global outcome, but the small number of studies providing usable data and their poor quality, suggest that this evidence should be interpreted with caution. At present, there is no convincing evidence either to support or refute the use of antidepressants in treating depression in people with schizophrenia.
Antipsychotics are first-line treatment of schizophrenia. They are often accompanied by adjunctive treatments, such as antidepressant AD or mood stabilizer MS , although there is only limited information of their use in first-episode schizophrenia. This study aimed to investigate AD and MS initiation and factors associated with initiation in persons with first-episode schizophrenia. Cox proportional hazard models were used to investigate factors associated with AD or MS initiation. Among persons with first-episode schizophrenia, Female gender, younger age, and benzodiazepine use were associated with higher risk of AD and MS initiation. The number of previous psychoses was associated with decreased risk of AD and increased risk of MS initiation.
We focused on the application of antidepressants in schizophrenia treatment in this review. Augmentation of antidepressants with antipsychotics is a common clinical practice to treat resistant symptoms in schizophrenia, including depressive symptoms, negative symptoms, comorbid obsessive—compulsive symptoms, and other psychotic manifestations. However, recent systematic review of the clinical effects of antidepressants is lacking.
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Diagnosis of schizophrenia involves ruling out other mental health disorders and determining that symptoms are not due to substance abuse, medication or a medical condition. Determining a diagnosis of schizophrenia may include:.
Все файлы прошли проверку, в них не было обнаружено ничего необычного, а это означало, что ТРАНСТЕКСТ безукоризненно чист. На что же уходит такая уйма времени. - спросил он, обращаясь в пустоту и чувствуя, как покрывается. Наверное, придется потревожить этой новостью Стратмора. Проверка на наличие вируса, - решительно сказал он себе, стараясь успокоиться.
Самое разрушительное последствие - полное уничтожение всего банка данных, - продолжал Джабба, - но этот червь посложнее. Он стирает только те файлы, которые отвечают определенным параметрам.