Antidepressants for the negative symptoms of schizophrenia.

摘要: Background Negative symptoms are common in people with schizophrenia and often difficult to treat antipsychotic drugs. Treatment involves the use of various add-on medications such as antidepressants. Objectives To review effects combination antidepressant drug treatment for management negative schizophrenia-like psychoses. Search strategy We searched Cochrane Schizophrenia Group's register (January 2004). also contacted authors included studies order identify further trials. Selection criteria all randomised controlled trials comparing combinations antipsychotics alone prominent and/or Data collection analysis Working independently, we selected critically appraised studies, extracted data analysed on an intention-to-treat basis. Where possible appropriate calculated relative risk RR) their 95% confidence intervals (CI), number needed (NNT). Main results five (all short-term, total N=190). found no significant difference 'leaving study early any reason' between plus control group (n=90, 3 RCTs, RR 3.0 CI 0.35 26.04). Leaving due adverse events (n=64, 2 5.0 0.26 97.0) leaving inefficacy (n=34, 1 RCT, 0.13 68.84) showed two groups. In terms clinical response, participants treated a statistically greater improvement (n=30, WMD -1.0 -1.61 -0.39) significantly lower severity at endpoint -0.9 -1.55 -0.25) Clinical Global Impression Scale than those alone. More allocated therapy had clinically compared given placebo (n=60, 0.56 0.32 0.97, NNT 34). Significant differences favour were seen different aspects symptoms: 'affective flattening' -7.0 -10.37 -3.63), 'alogia' (n=26, -3.00 -5.14 -0.86) 'avolition' -3.0 -5.04 -0.96). No was groups regards outcome 'at least one event' (n=84, 1.80 0.66 4.90). For movement disorders other effects, that provided usable these outcomes. There outcomes compliance, cost, social cognitive functioning, relapse, recurrence symptoms, rehospitalisation or quality life. medium long term data. Authors' conclusions The antidepressants may be effective treating schizophrenia, but amount information is currently too limited allow firm conclusions. Large, pragmatic, well-designed reported justified.