Plasky P
McLean Hospital, Belmont, MA 02178.
Schizophr Bull. 1991;17(4):649-57. doi: 10.1093/schbul/17.4.649.
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.
精神分裂症患者中抑郁很常见，但常常未得到治疗。对最近七项研究的综述显示，在急性精神病性阶段缓解后，三环类抗抑郁药（TCA）与抗精神病药物联合使用时可能有效，且使精神病性症状加重的风险极小。然而，未发现TCA对精神分裂症的无力或“阴性症状”有效。同时使用TCA和抗精神病药物可导致两者的血药浓度升高，以及抗胆碱能副作用风险增加。文中描述了在精神分裂症中使用非三环类抗抑郁药的一些有前景的研究工作。
