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Patients with schizophrenia often develop depressive symptoms, and about 30% receive antidepressants. In individual studies, adding antidepressants to antipsychotics benefited these patients, but changes in practice often require more substantial evidence. Now, investigators have systematically reviewed 82 randomized, controlled studies (91% double-blind) published in 1964–2014 involving 3608 patients with schizophrenia who received antipsychotics plus antidepressants or control (placebo or no adjunctive treatment).
Participants were inpatients or outpatients (61% male; mean age, 40; mean duration of illness, 11 years; mean chlorpromazine equivalents, 604 mg/day). Overall, add-on antidepressants (mean fluoxetine equivalent, 31 mg/day) were s…