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Pharmacopsychiatry 2017; 50(04): 136-144
DOI: 10.1055/s-0043-106436
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Add-on Antidepressants in the Naturalistic Treatment of Schizophrenia Spectrum Disorder – When, Who, and How?

Rebecca Schennach
1   Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
17   Schoen Clinic Roseneck, Prien am Chiemsee, Germany
,
Michael Obermeier
1   Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
,
Florian Seemüller
1   Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
,
Markus Jäger
1   Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
,
Max Schmauss
2   Psychiatric Clinic, District Hospital Augsburg, Augsburg, Germany
,
Gerd Laux
3   Psychiatric Clinic, Inn-Salzach Hospital, Wasserburg/Inn, Germany
,
Herbert Pfeiffer
4   Psychiatric Clinic, Isar-Amper Hospital, Munich-Haar, Germany
,
Dieter Naber
5   Department of Psychiatry, University of Hamburg, Hamburg, Germany
,
Lutz G. Schmidt
6   Department of Psychiatry, Johannes Gutenberg-University of Mainz, Mainz, Germany
,
Wolfgang Gaebel
7   Department of Psychiatry and Psychotherapy, Heinrich-Heine-University, Düsseldorf, Germany
,
Joachim Klosterkötter
8   Department of Psychiatry, University of Cologne, Köln, Germany
,
Isabella Heuser
9   Department of Psychiatry, Charite Berlin, Campus Benjamin Franklin, Berlin, Germany
,
Wolfgang Maier
10   Department of Psychiatry, University of Bonn, Bonn, Germany
,
Matthias R. Lemke
11   Psychiatric Clinic, Alsterdorf Hospital, Hamburg, Germany
,
Eckart Rüther
12   Department of Psychiatry, University of Göttingen, Göttingen, Germany
,
Stefan Klingberg
13   Department of Psychiatry, University of Tübingen, Tübingen, Germany
,
Markus Gastpar
14   Department of Psychiatry, University of Essen, Essen, Germany
,
Ilja Spellmann
15   Psychiatric Clinic, District Hospital Kaufbeuren, Kaufbeuren, Germany
,
Richard Musil
1   Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
,
Hans-Jürgen Möller
1   Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
,
Michael Riedel
1   Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
16   Psychiatric Clinic Nordschwarzwald, Calw, Germany
› Author Affiliations
Further Information

Publication History

received 01 September 2016
revised 15 February 2017

accepted 13 March 2017

Publication Date:
15 May 2017 (online)

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Abstract

Introduction

The aim of this study was to evaluate antidepressant add-on treatment within the acute treatment of schizophrenia spectrum disorder patients.

Methods

Antidepressant add-on was evaluated in 365 patients within a naturalistic multicenter study. Patients with/without antidepressant add-on were compared regarding clinical and treatment-related variables, response and remission, and remission of depressive and negative symptoms. The efficacy of antidepressant add-on treatment was furthermore analyzed applying marginal structure models.

Results

Twenty-three percent of the patients received antidepressant add-on for a mean duration of 50.28 (33.42) days. Patients with the diagnosis of a schizoaffective disorder, multiple illness episodes, and a longer duration of their illness as well as those with significantly fewer baseline positive symptoms, more negative and depressive symptoms, more side effects, and less subjective well-being were augmented with antidepressants. At discharge no significant effect of antidepressant add-on treatment was observed in terms of a 25% improvement (p=0.2623), a 50% improvement (p=0.3946), remission (p=0.0552), or remission of depressive (p=0.6336) and negative symptoms (p=0.8756). Also, when analyzing marginal structure models considering the diagnostic subgroups, no significant effect was found.

Discussion

Add-on with antidepressants is common. A final recommendation in terms of this strategy’s efficacy cannot be given.

Key words

schizophrenia spectrum disorder - antidepressants - add-on - prescribing pattern - efficacy
 

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