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McLean Hospital, Belmont, MA 02178.
Depression in schizophrenic patients is common but often untreated. A review of seven recent studies reveals that tricyclic antidepressants (TCAs) can be effective when used in conjunction with neuroleptic medication after the acute psychotic phase has resolved, with only minimal risk of exacerbation of psychotic symptoms. TCAs were not found to be effective against anergy or the "negative symptoms" of schizophrenia, however. The simultaneous use of TCAs and neuroleptics can result in increased blood levels of each, as well as increased risk of anticholinergic side effects. Some promising work in the use of nontricyclic antidepressants in schizophrenia is described.
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