November 1978

Use of Antidepressant Drugs in Schizophrenia

Author Affiliations

From the Section on Neuropsychopharmacology, Adult Psychiatry Branch, National Institute of Mental Health, Bethesda, Md. Dr Siris is presently with the Affective Disorders Research Service, New York State Psychiatric Institute, New York. Dr Docherty is presently with the Department of Psychiatry, Yale University, New Haven, Conn.

Arch Gen Psychiatry. 1978;35(11):1368-1377. doi:10.1001/archpsyc.1978.01770350094009

• This review surveys the therapeutic efficacy of tricyclic antidepressants and monoamine oxidase inhibitors in schizophrenic patients. In general, the use of these drugs alone was found not to be warranted in schizophrenia, except perhaps in the so-called pseudoneurotic subgroup. In most cases, combinations of antidepressants and phenothiazines were not more beneficial than phenothiazines alone. In particular, the conditions of agitated patients and patients with histories of social deviance dating back to childhood were often made worse by the addition of an antidepressant. However, when the patients who demonstrated symptoms of clinical depression other than anergia were isolated from several of these studies, it was found that they constituted a subgroup that was often benefited by use of these combinations. Favorable and unfavorable clinical response patterns are discussed, and recommendations for future research are outlined.