Table 1.
Antidepressants as Add-On Treatment in Schizophrenia: Randomized Placebo-Controlled Trials
Table 1a. Antidepressants in Treatment of Negative and Positive Symptoms
| AntidepressantGroup | Author(s) | Year | Antidepressant |
Dose,
Mg |
Antipsychotic | N |
Duration,
wk |
Efficacy
Measures |
Outcome |
|---|---|---|---|---|---|---|---|---|---|
| TCA | Collins and Dungas | 1967 | Amitryptiline | n/r | Perphenazine | 87 | 12 | Wing scale | Improvement in amitriptyline group. |
| Waehrens and Gerlach |
1980 | Maprotiline | n/r | Various FGAs | 20 | 16 | n/r | No between group differences. | |
| Siris et al. | 1991 | Imipramine | n/r | Depot FGAs | 14 | 24 | n/r | Improvement in negative symptoms in imipramine group. | |
| SSRI | Spina et al. | 1994 | Fluoxetine | 20 | Various FGAs | 34 | 12 | SANS, SAPS | Improvement on the SANS in fluoxetine group. No change on the SAPS in either group. |
| Goff et al. | 1995 | Fluoxetine | 20 | Depot FGAs | 41 | 6 | BPRS | Greater improvement in fluoxetine group on the BPRS negative subscale. No change on the BPRS positive subscale in either group. | |
| Buchanan et al. | 1996 | Fluoxetine | 20 | Clozapine | 33 | 8 | SANS | No change in either group. | |
| Arango et al. | 2000 | Fluoxetine | 20–40 | Various FGAs | 32 | 8 | BPRS, SANS | No change in either group. | |
| Poyurovski et al.* | 2002 | Fluoxetine | 20 | Olanzapine | 30 | 8 | SAPS, SANS | Greater reduction on the SAPS in placebo group than in fluoxetine group. | |
| Bustillo et al.* | 2003 | Fluoxetine | 60 | Olanzapine | 31 | 8 | PANSS | No change in either group. | |
| Silver and Nassar | 1992 | Fluvoxamine | 50–100 | Various FGAs | 30 | 7 | SANS, SAPS | Improvement on the SANS in fluvoxamine group. No change on the SAPS in either group. | |
| Silver et al. | 2000 | Fluvoxamine | 50–100 | Various FGAs | 53 | 6 | SANS, SAPS | Improvement on the SANS in fluvoxamine group. No change on the SAPS in either group. | |
| Lee et al. | 1998 | Sertraline | 50 | Haloperidol | 36 | 8 | PANSS | No change in either group. | |
| Mulholand et al.* | 2003 | Sertraline | 50 | Variopus FGAs, risperidone | 26 | 8 | BPRS, SANS | No change in either group. | |
| Salokangas et al. | 1996 | Citalopram | 20–40 | Various FGAs | 90 | 12 | PANSS | Decrease on the PANSS total scale in both groups, no between group differences. | |
| Friedman et al. | 2005 | Citalopram | 40 | Various SGAs | 19 | 24 | PANSS | No change in either group. | |
| Iancu et al. | 2010 | Escitalopram | 20 | Various FGAs and SGAs | 38 | 10 | PANSS, SANS, CGI | No change in either group. | |
| Jockers et al. | 2005 | Paroxetine | 30 | Various FGAs and SGAs | 29 | 12 | PANSS | Improvement in paroxetine group on the PANSS negative subscale. | |
| NRI | Schutz and Berk | 2001 | Reboxetine | 8 | Haloperidol | 30 | 8 | PANSS | No change in either group. |
| Poyurovski et al.* | 2003 | Reboxetine | 4 | Olanzapine | 26 | 6 | SANS, SAPS | No change in either group. | |
| SNRI | Mico et al. | 2011 | Duloxetine | 60 | Clozapine | 33 | 16 | BPRS, PANSS |
Improvement on the BPRS, PANSS negative, PANSS general and PANSS total (sub)scales in duloxetine group. |
| NDRI | Evins et al.* | 2005 | Bupropion | 300 | Clozapine, FGAs, SGAs | 53 | 12 | SANS | No change in either group. |
| Weiner et al.* | 2012 | Bupropion | 300 | Clozapine, FGAs, SGAs | 32 | 12 | n/a | No change in either group | |
| Receptor- blocking antidepressants | Decina et al. | 1994 | Trazodone | n/r | n/r | 47 | 6 | BPRS, SANS | Improvement on the BPRS and SANS in trazodone group. |
| Hayashi et al. | 1997 | Trazodone | 50–200 | n/r | 39 | 5 | BPRS, SANS | Improvement on the BPRS negative subscale in trazodone group. | |
| Stryjer et al.* | 2010 | Trazodone | 100 | n/r | 13 | 1 | PANSS | No change in either group. | |
| Shiloh et al. | 2002 | Mianserin | 30 | Various FGAs | 18 | 6 | BPRS, SAPS, SANS | Improvement on the BPRS in mianserin group. | |
| Hayashi et al. | 1997 | Mianserin | 20–60 | n/r | 39 | 5 | BPRS, SANS | Improvement on the BPRS and SANS in mianserin group. | |
| Poyurovski et al. | 2003 | Mianserin | 15 | Various FGAs | 30 | 4 | SAPS, SANS | No change in either group. | |
| Berk et al. | 2001 | Mirtazapine | 30 | Haloperidol | 30 | 6 | PANSS | Improvement on the PANSS negative subscale in mirtazapine group. | |
| Zoccali et al. | 2004 | Mirtazapine | 30 | Clozapine | 24 | 8 | SANS, SAPS, BPRS | Improvement on the SANS and BPRS general subscale in mirtazapine group. | |
| Joffe et al. | 2009 | Mirtazapine | 30 | Various FGAs | 39 | 6 | PANSS | Improvement on the PANSS total and all PANSS subscales in mirtazapine group. | |
| Berk et al. | 2009 | Mirtazapine | 30 | Various SGAs | 40 | 6 | PANSS | No change in either group. | |
| Abbasi et al. | 2010 | Mirtazapine | 30 | Risperidone | 40 | 8 | PANSS | Improvement on the PANSS negative and PANSS total in mirtazapine group. | |
| Cho et al. | 2011 | Mirtazapine | n/r | Risperidone | 21 | 8 | PANSS, SANS |
Improvement on the PANSS negative and SANS in mirtazapine group. | |
| Caforio et al. | 2013 | Mirtazapine | 30 | Olanzapine | 28 | 8 | PANSS | Improvement on PANSS negative subscale in mirtazapine group. |