[SSRIs and depressive symptoms in schizophrenia: a systematic review]

Patients with schizophrenia frequently have depressive symptoms. Current guidelines do not provide specific recommendations regarding the treatment of these symptoms, nor do they mention the role that selective serotonin reuptake inhibitors (ssris) can play in the treatment.
AIM: To investigate whether ssris are more effective than placebo in treating depressive symptoms in patients with schizophrenia.
METHOD: We searched the literature systematically using PubMed, embase, Cochrane Library and Psycinfo. We selected articles on the basis of inclusion and exclusion criteria and the methodologies used and compared the severity of patients symptoms before and after treatment.
RESULTS: We found only four published studies of randomised, double blind, placebo-controlled trials. These showed that an ssri was significantly more effective than a placebo (the difference being 0.4 - 6.7 points on the Hamilton Depression Rating Scale and 0.2 - 2.6 on the Calgary Depression Scale for Schizophrenia).
CONCLUSION: There are indications that ssris are effective for the treatment of depressive symptoms in patients with schizophrenia. However, the total sample size was limited and individual studies had several methodological limitations.