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Efficacy and safety of antidepressant augmentation of continued antipsychotic treatment in patients with schizophrenia

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Galling, B, Vernon, JA, Pagsberg, AK, Wadhwa, A, Grudnikoff, E, Seidman, AJ, Tsoy-Podosenin, M, Poyurovsky, M, Kane, JM & Correll, CU 2018, 'Efficacy and safety of antidepressant augmentation of continued antipsychotic treatment in patients with schizophrenia' Acta Psychiatrica Scandinavica, bind 137, nr. 3, s. 187-205. https://doi.org/10.1111/acps.12854

APA

CBE

Galling B, Vernon JA, Pagsberg AK, Wadhwa A, Grudnikoff E, Seidman AJ, Tsoy-Podosenin M, Poyurovsky M, Kane JM, Correll CU. 2018. Efficacy and safety of antidepressant augmentation of continued antipsychotic treatment in patients with schizophrenia. Acta Psychiatrica Scandinavica. 137(3):187-205. https://doi.org/10.1111/acps.12854

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Author

Galling, B ; Vernon, J A ; Pagsberg, A K ; Wadhwa, A ; Grudnikoff, E ; Seidman, A J ; Tsoy-Podosenin, M ; Poyurovsky, M ; Kane, J M ; Correll, C U. / Efficacy and safety of antidepressant augmentation of continued antipsychotic treatment in patients with schizophrenia. I: Acta Psychiatrica Scandinavica. 2018 ; Bind 137, Nr. 3. s. 187-205.

Bibtex

@article{b6a80274276b4e6db141d82829813836,
title = "Efficacy and safety of antidepressant augmentation of continued antipsychotic treatment in patients with schizophrenia",
abstract = "OBJECTIVE: To evaluate the efficacy and safety of antidepressant augmentation of antipsychotics in schizophrenia.METHODS: Systematic literature search (PubMed/MEDLINE/PsycINFO/Cochrane Library) from database inception until 10/10/2017 for randomized, double-blind, efficacy-focused trials comparing adjunctive antidepressants vs. placebo in schizophrenia.RESULTS: In a random-effects meta-analysis (studies = 42, n = 1934, duration = 10.1 ± 8.1 weeks), antidepressant augmentation outperformed placebo regarding total symptom reduction [standardized mean difference (SMD) = -0.37, 95{\%} confidence interval (CI) = -0.57 to -0.17, P < 0.001], driven by negative (SMD = -0.25, 95{\%} CI = -0.44-0.06, P = 0.010), but not positive (P = 0.190) or general (P = 0.089) symptom reduction. Superiority regarding negative symptoms was confirmed in studies augmenting first-generation antipsychotics (FGAs) (SMD = -0.42, 95{\%} CI = -0.77, -0.07, P = 0.019), but not second-generation antipsychotics (P = 0.144). Uniquely, superiority in total symptom reduction by NaSSAs (SMD = -0.71, 95{\%} CI = -1.21, -0.20, P = 0.006) was not driven by negative (P = 0.438), but by positive symptom reduction (SMD = -0.43, 95{\%} CI = -0.77, -0.09, P = 0.012). Antidepressants did not improve depressive symptoms more than placebo (P = 0.185). Except for more dry mouth [risk ratio (RR) = 1.57, 95{\%} CI = 1.04-2.36, P = 0.03], antidepressant augmentation was not associated with more adverse events or all-cause/specific-cause discontinuation.CONCLUSIONS: For schizophrenia patients on stable antipsychotic treatment, adjunctive antidepressants are effective for total and particularly negative symptom reduction. However, effects are small-to-medium, differ across antidepressants, and negative symptom improvement seems restricted to the augmentation of FGAs.",
keywords = "Journal Article",
author = "B Galling and Vernon, {J A} and Pagsberg, {A K} and A Wadhwa and E Grudnikoff and Seidman, {A J} and M Tsoy-Podosenin and M Poyurovsky and Kane, {J M} and Correll, {C U}",
note = "{\circledC} 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",
year = "2018",
month = "3",
doi = "10.1111/acps.12854",
language = "English",
volume = "137",
pages = "187--205",
journal = "Acta Psychiatrica Scandinavica",
issn = "0001-690X",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - Efficacy and safety of antidepressant augmentation of continued antipsychotic treatment in patients with schizophrenia

AU - Galling, B

AU - Vernon, J A

AU - Pagsberg, A K

AU - Wadhwa, A

AU - Grudnikoff, E

AU - Seidman, A J

AU - Tsoy-Podosenin, M

AU - Poyurovsky, M

AU - Kane, J M

AU - Correll, C U

N1 - © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2018/3

Y1 - 2018/3

N2 - OBJECTIVE: To evaluate the efficacy and safety of antidepressant augmentation of antipsychotics in schizophrenia.METHODS: Systematic literature search (PubMed/MEDLINE/PsycINFO/Cochrane Library) from database inception until 10/10/2017 for randomized, double-blind, efficacy-focused trials comparing adjunctive antidepressants vs. placebo in schizophrenia.RESULTS: In a random-effects meta-analysis (studies = 42, n = 1934, duration = 10.1 ± 8.1 weeks), antidepressant augmentation outperformed placebo regarding total symptom reduction [standardized mean difference (SMD) = -0.37, 95% confidence interval (CI) = -0.57 to -0.17, P < 0.001], driven by negative (SMD = -0.25, 95% CI = -0.44-0.06, P = 0.010), but not positive (P = 0.190) or general (P = 0.089) symptom reduction. Superiority regarding negative symptoms was confirmed in studies augmenting first-generation antipsychotics (FGAs) (SMD = -0.42, 95% CI = -0.77, -0.07, P = 0.019), but not second-generation antipsychotics (P = 0.144). Uniquely, superiority in total symptom reduction by NaSSAs (SMD = -0.71, 95% CI = -1.21, -0.20, P = 0.006) was not driven by negative (P = 0.438), but by positive symptom reduction (SMD = -0.43, 95% CI = -0.77, -0.09, P = 0.012). Antidepressants did not improve depressive symptoms more than placebo (P = 0.185). Except for more dry mouth [risk ratio (RR) = 1.57, 95% CI = 1.04-2.36, P = 0.03], antidepressant augmentation was not associated with more adverse events or all-cause/specific-cause discontinuation.CONCLUSIONS: For schizophrenia patients on stable antipsychotic treatment, adjunctive antidepressants are effective for total and particularly negative symptom reduction. However, effects are small-to-medium, differ across antidepressants, and negative symptom improvement seems restricted to the augmentation of FGAs.

AB - OBJECTIVE: To evaluate the efficacy and safety of antidepressant augmentation of antipsychotics in schizophrenia.METHODS: Systematic literature search (PubMed/MEDLINE/PsycINFO/Cochrane Library) from database inception until 10/10/2017 for randomized, double-blind, efficacy-focused trials comparing adjunctive antidepressants vs. placebo in schizophrenia.RESULTS: In a random-effects meta-analysis (studies = 42, n = 1934, duration = 10.1 ± 8.1 weeks), antidepressant augmentation outperformed placebo regarding total symptom reduction [standardized mean difference (SMD) = -0.37, 95% confidence interval (CI) = -0.57 to -0.17, P < 0.001], driven by negative (SMD = -0.25, 95% CI = -0.44-0.06, P = 0.010), but not positive (P = 0.190) or general (P = 0.089) symptom reduction. Superiority regarding negative symptoms was confirmed in studies augmenting first-generation antipsychotics (FGAs) (SMD = -0.42, 95% CI = -0.77, -0.07, P = 0.019), but not second-generation antipsychotics (P = 0.144). Uniquely, superiority in total symptom reduction by NaSSAs (SMD = -0.71, 95% CI = -1.21, -0.20, P = 0.006) was not driven by negative (P = 0.438), but by positive symptom reduction (SMD = -0.43, 95% CI = -0.77, -0.09, P = 0.012). Antidepressants did not improve depressive symptoms more than placebo (P = 0.185). Except for more dry mouth [risk ratio (RR) = 1.57, 95% CI = 1.04-2.36, P = 0.03], antidepressant augmentation was not associated with more adverse events or all-cause/specific-cause discontinuation.CONCLUSIONS: For schizophrenia patients on stable antipsychotic treatment, adjunctive antidepressants are effective for total and particularly negative symptom reduction. However, effects are small-to-medium, differ across antidepressants, and negative symptom improvement seems restricted to the augmentation of FGAs.

KW - Journal Article

U2 - 10.1111/acps.12854

DO - 10.1111/acps.12854

M3 - Journal article

VL - 137

SP - 187

EP - 205

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

SN - 0001-690X

IS - 3

ER -

ID: 52736217