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First-generation versus second-generation antipsychotic drugs for depression in schizophrenia

Published online by Cambridge University Press:  23 March 2020

T. Acciavatti
Affiliation:
University “G.D. Annunzio” Chieti, Neuroscienze- Imaging e Scienze Cliniche, Chieti, Italy
S. Marini
Affiliation:
University “G.D. Annunzio” Chieti, Neuroscienze- Imaging e Scienze Cliniche, Chieti, Italy
E. Cinosi
Affiliation:
University “G.D. Annunzio” Chieti, Neuroscienze- Imaging e Scienze Cliniche, Chieti, Italy
L. Di Tizio
Affiliation:
University “G.D. Annunzio” Chieti, Neuroscienze- Imaging e Scienze Cliniche, Chieti, Italy
L. Di Caprio
Affiliation:
University “G.D. Annunzio” Chieti, Neuroscienze- Imaging e Scienze Cliniche, Chieti, Italy
D. Viceconte
Affiliation:
University “G.D. Annunzio” Chieti, Neuroscienze- Imaging e Scienze Cliniche, Chieti, Italy
L. Matteo
Affiliation:
University “G.D. Annunzio” Chieti, Neuroscienze- Imaging e Scienze Cliniche, Chieti, Italy
D.I. Giuseppe
Affiliation:
University “G.D. Annunzio” Chieti, Neuroscienze- Imaging e Scienze Cliniche, Chieti, Italy
G. Martinotti
Affiliation:
University “G.D. Annunzio” Chieti, Neuroscienze- Imaging e Scienze Cliniche, Chieti, Italy
M. Di Giannantonio
Affiliation:
University “G.D. Annunzio” Chieti, Neuroscienze- Imaging e Scienze Cliniche, Chieti, Italy

Abstract

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Introduction

A certain degree of depressive symptoms is common in schizophrenic patients. The assessment and treatment of depressive symptoms in schizophrenia is clinically challenging.

Objectives

We conducted a cross-sectional study to investigate the depressive dimension of schizophrenic patients.

Aims

The aim was to evaluate the effect of pharmacotherapy on depressive symptomatology.

Methods

Thirty-four outpatients (18-65 years old) with stable schizophrenia in monotherapy with FGAs or SGAs. We evaluated: depressive symptoms with Calgary Depression Scale for Schizophrenia; positive and negative symptoms (with Positive and Negative Symptom Scale); neurocognition (with Matrics Cognitive Consensus Battery); social cognition (with Facial Emotional Identification Test); social functioning (with Personal and Social Performance Scale and with UCSD Performance-based Skills Assessment). Collected data underwent statistical analyses.

Results

A SGAs therapy was associated with: lower depressive symptoms (mean SGAs group = 4.0; mean FGAs group = 7.86, P < 0.05); lower mean positive symptoms (mean SGAs group = 12.65; mean FGAs group = 17.43, P < 0.05); lower negative symptoms (mean SGAs group = 21.35; mean FGAs group = 29.07, P < 0.05); lower scores on the PANSS-total (mean SGAs group = 71.05; mean FGAs group = 91.86, P < 0.01). After correction for multiple variables, the SGAs group still had significantly lower values towards the FGAs group (P < 0.05).

Conclusions

Our study support the notion that switch from a FGA to a SGA could be a relatively simple first-step for the treatment of this condition. Atypical antipsychotics might exercise antidepressant effects with different potential mechanism including: remission of a FGA-induced depression and action on of 5-hydroxytryptamine, dopamine [other than postsynaptic D2], and α1-noradrenergic receptor sites.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EW502
Copyright
Copyright © European Psychiatric Association 2014
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