[Depressive syndromes during schizophrenic psychoses]

Depressive syndromes are often seen in schizophrenics. Three forms have to be distinguished: 1. Depressive reactions of acute psychotic symptoms. Primary therapy should be done with neuroleptics. 2. Psychodynamically understandable depressed mood after psychosis and/or hospitalization. Psycho- and sociotherapy is necessary. 3. Very often and most heavy are pharmacogenic depressions following recovery from schizophrenic symptoms (under fluphenazine-decanoate up to about three quarters of the patients). A controlled study showed that they are caused by neuroleptic drugs. First and best therapy is to reduce or even discontinue the application of the neuroleptic. Antiparkinsonian drugs intravenously applied help within one minute. The recovery from depressive syndromes can also be accelerated if reduction of neuroleptic dosage is sometime assisted by antidepressants.