[Antidepressive drug treatment of the schizophrenic patient]

A review of the international literature concerned with controlled studies of antidepressants in schizophrenics shows that the therapeutic efficacy of these agents is primarily a function of the phase in the disorder during which they are administered. During the acute phases, administration of antidepressants, with or without neuroleptics, is to be avoided since it can aggravate florid symptomatology. In "depressed" schizophrenics in the post-psychotic phase, some studies have favored combination of an antidepressant with a neuroleptic, in particular for prevention of disorders of mood, as well as of suicidal behavior. Nevertheless, from the methodologic standpoint, they are still numerous problems in differentiation between depressive symptomatology and akinetic symptoms or deficit symptomatology. Finally, in terms of efficacy of antidepressants for negative or deficit symptomatology, there are some data suggesting efficacy of a combination of an antidepressant with the standard neuroleptic treatment. Nevertheless, confirmation of such efficacy would require comparison with the disinhibitory neuroleptics.