Hostname: page-component-7c8c6479df-nwzlb Total loading time: 0 Render date: 2024-03-28T04:38:46.581Z Has data issue: false hasContentIssue false

Antidepressants for the treatment of depression in people with schizophrenia: a systematic review

Published online by Cambridge University Press:  13 May 2003

C. WHITEHEAD
Affiliation:
Bro Taf Health Authority and University of Wales College of Medicine, Cardiff; and Department of Psychiatry, University of Bristol
S. MOSS
Affiliation:
Bro Taf Health Authority and University of Wales College of Medicine, Cardiff; and Department of Psychiatry, University of Bristol
A. CARDNO
Affiliation:
Bro Taf Health Authority and University of Wales College of Medicine, Cardiff; and Department of Psychiatry, University of Bristol
G. LEWIS
Affiliation:
Bro Taf Health Authority and University of Wales College of Medicine, Cardiff; and Department of Psychiatry, University of Bristol

Abstract

Background. Depression is common in people with schizophrenia and is associated with substantial morbidity and an increased risk of suicide. Our aim was to review systematically all the randomized controlled trials that have investigated the clinical effectiveness of antidepressant medication in the treatment of depression in people who also suffer with schizophrenia.

Method. Electronic searches of ClinPsych, the Cochrane Library, the Cochrane Schizophrenia Group's Register of Trials, EMBASE and Medline were completed. Reference lists from identified articles were hand searched.

Results. Eleven small studies were identified and all randomized fewer than 30 subjects to each group. We could only perform analyses on a subset of the trials. For five trials (aggregate N=209) the proportion improved in the antidepressant group was 26% (95% CI 10% to 42%) higher than in the placebo group. In six studies (aggregate N=267) the standardized mean difference on the Hamilton Rating Scale for Depression at the end of the trial was −0·27 (95% CI −0·7 to 0·2). There was no evidence that antidepressant treatment given during the stable phase of illness led to a deterioration of psychotic symptoms in the included trials.

Conclusions. The literature reviewed was, overall, of poor quality and only a small number of trials could contribute towards the meta-analysis. The results provide weak evidence for the effectiveness of antidepressants in those with schizophrenia and depression and could be explained by publication bias. We need further research to determine the best approach towards treating depression in people with schizophrenia.

Type
Review Article
Copyright
© 2003 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)