{"id":38636,"date":"2011-06-22T08:10:04","date_gmt":"2011-06-22T12:10:04","guid":{"rendered":"https:\/\/today.uconn.edu\/?p=38636"},"modified":"2011-07-06T10:34:29","modified_gmt":"2011-07-06T14:34:29","slug":"study-finds-increasing-use-of-antidepressants-in-treating-some-symptoms-of-schizophrenia","status":"publish","type":"post","link":"https:\/\/today.uconn.edu\/2011\/06\/study-finds-increasing-use-of-antidepressants-in-treating-some-symptoms-of-schizophrenia\/","title":{"rendered":"Study Finds Antidepressants May Help in Treating Schizophrenia"},"content":{"rendered":"
\"\"<\/a>
Megan Ehret, assistant professor of pharmacy practice. (Peter Morenus\/UConn Photo)<\/figcaption><\/figure>\n

Schizophrenia is a complex and chronic mental disorder affecting more than 2 million people in the United States.<\/p>\n

Finding appropriate medication to address the various symptoms of schizophrenia and improve the quality of life of these individuals is a constant challenge for psychiatrists and other health care professionals.<\/p>\n

While antipsychotic medication remains the primary form of treatment for the so-called \u201cpositive\u201d symptoms<\/a> of schizophrenia (delusions, hallucinations, thought disorders), there is mounting interest in the medical community in using antidepressants – combined with antipsychotics \u2013 as a treatment for the disorder\u2019s negative symptoms. The negative symptoms of schizophrenia are similar to those found in individuals with depression and are characterized by a lack of motivation or desire, lack of social relationships, and blunted affect and emotion.<\/p>\n

Megan Ehret, a University of Connecticut pharmacologist specializing in mental disorders, recently surveyed the records of more than 1,500 schizophrenic patients at a Hartford, CT mental health center and found that more than 1 in 4 patients were given antidepressants as add-on medications at time of discharge.<\/p>\n

While the reasons the patients received antidepressants were not identified in the study, Ehret notes that a vast majority of the patients did not have a co-diagnosis of depression, anxiety, or personality disorder. Ehret concludes, therefore, that the antidepressants were most likely given for the treatment of the negative symptoms of schizophrenia and the patients’ depressive state.<\/p>\n

\u201cThis is a potentially important contribution to the field as there has been increased interest in recent years about both depressive and so-called \u201cnegative symptoms\u201d that seem to occur in some patients with schizophrenia but not all,\u201d says Dr. John W. Goethe, a psychiatrist and director of the Burlingame Center for Research and Education<\/a> at the Institute of Living (IOL) in Hartford, where the study took place. Goethe served as a co-author of the study, along with Bonnie L. Szarek, a research nurse and project coordinator at the IOL, which is a division of Hartford Hospital.<\/p>\n

\u201cPrior studies suggest that in clinical practice there has been an increase in prescribing antidepressants along with the usual antipsychotic medications that these patients receive,\u201d Goethe says. \u201cWhile the rationale for this recently observed prescribing practice can only be inferred, it is possible that it is related to clinician-perceived depressive and\/or negative symptoms that co-exist with the psychotic symptoms, such as hallucinations and delusions.\u201d<\/p>\n

While more research is warranted, the results suggest that the diagnostic criteria associated with the symptoms of schizophrenia, and other related illnesses such as schizoaffective disorder, may need to be more clearly defined – and related treatment protocols amended – to reflect a growing use of antidepressants by the medical community.<\/p>\n

\u201cRight now people are using antidepressants in schizophrenia for a variety of reasons,\u201d Ehret says. \u201cThere is a lot of discussion in the area of psychology as to whether we are truly diagnosing schizophrenia or whether we are diagnosing schizoaffective disorder, which is another type of schizophrenia but has more of a mood component to it. There are many different reasons to use antidepressants and we want to be sure we are using them appropriately.\u201d<\/p>\n

The distinction in diagnosis is important as the American Psychiatric Association is in the process of amending its Diagnostic and Statistical Manual of Mental Disorders, 4th<\/sup> edition (DSM-IV<\/a>) and reviewing its definitions of different psychiatric illnesses. The APA expects to publish a new version, the DSM-V, in 2013.\u00a0 The manual is the primary resource for the diagnosis of psychiatric illnesses used by mental health professionals.<\/p>\n

Comprehensive Research<\/strong><\/p>\n

Ehret, an assistant professor of pharmacy practice in the University of Connecticut\u2019s School of Pharmacy<\/a>, presented her findings at the APA\u2019s annual meeting in Hawaii in May. Goethe praised Ehret\u2019s research and said he was unaware of any prior study that looked at so many demographic and clinical variables related to antidepressant use among schizophrenic patients or one that involved such a large patient sample.<\/p>\n

The details of the study are as follows: Ehret reviewed the case histories of 1,519 patients diagnosed with schizophrenia at the IOL between February 2000 and July 2009. The patients ranged in age from 18 to 64 with 40 being the average age.\u00a0 Of that total, 425 or 28 % were discharged on antidepressants, mainly selective serotonin reuptake inhibitors (SSRIs).<\/p>\n

Ehret said she was a bit surprised by the regularity with which the drugs were being prescribed.<\/p>\n

\u201cTwenty-eight percent is more than a quarter of the patients; that\u2019s a substantial number to think about when the use of antidepressants is not high up on the treatment protocol,\u201d Ehret says.<\/p>\n

The study showed that what type of schizophrenia a patient had – catatonic, paranoid, disorganized or the undifferentiated type – made no significant difference in whether they received antidepressants. \u00a0The patient\u2019s age, sex, length of stay, and rate of readmission also did not appear to be a factor.<\/p>\n

Interestingly, despite their regular use, antidepressants did not substantially reduce patients\u2019 length of stay at the institution or reduce their readmission rate when compared to patients not on the drugs. Nor, says Ehret, did the use of antidepressant drugs appear to significantly increase length of stay, readmission rate, or cause substantial side effects when interacting with other drugs.<\/p>\n

\u201cRight now all we can say with this study is that these antidepressants aren\u2019t going to hurt you. You\u2019re going to do at least as well as people who don\u2019t get them,\u201d Ehret says. \u201cWe don\u2019t know how much better you can get with them. There have been several small studies showing you can get better, but we don\u2019t know.\u201d<\/p>\n

If it is found that antidepressants do indeed improve the quality of life for patients with schizophrenia, than the current medical protocols may need to be amended, Ehret says. Clarifying the issue is important in the interest of providing quality care. \u00a0Mental health professionals know that most patients with schizophrenia respond better the earlier treatment begins.<\/p>\n

\u201cAs a pharmacist, I know that the quicker you treat someone with schizophrenia, the better their long term prognosis,\u201d says Ehret. \u201cI also know that the more options you have available to a patient, the better. What we need to find out is \u2013 is there a combination of antipsychotic medications and antidepressants that works best; should we alter the DSM guidelines; when is it best to start these medications and what is the best dose to start on?\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Study finds increasing use of antidepressants in treating schizophrenia.<\/p>\n","protected":false},"author":21,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_crdt_document":"","wds_primary_category":0,"wds_primary_series":0,"wds_primary_attribution":0,"footnotes":""},"categories":[2076,1],"tags":[],"magazine-issues":[],"coauthors":[56],"class_list":["post-38636","post","type-post","status-publish","format-standard","hentry","category-research","category-uncategorized"],"pp_statuses_selecting_workflow":false,"pp_workflow_action":"current","pp_status_selection":"publish","acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-05-06 09:43:26","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/38636","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/users\/21"}],"replies":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/comments?post=38636"}],"version-history":[{"count":5,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/38636\/revisions"}],"predecessor-version":[{"id":39840,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/38636\/revisions\/39840"}],"wp:attachment":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media?parent=38636"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/categories?post=38636"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/tags?post=38636"},{"taxonomy":"magazine-issue","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/magazine-issues?post=38636"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/coauthors?post=38636"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}