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

• Published in: European psychiatry Vol. 33; no. S1; p. S245
• Main Authors: Corbo, M, Acciavatti, T, Marini, S, Cinosi, E, Di Tizio, L, Di Caprio, L, Viceconte, D, Matteo, L, Giuseppe, D.I, Martinotti, G, Di Giannantonio, M
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01.03.2016
• Subjects: Internal Medicine; Psychiatry
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2016.01.620

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.