Escitalopram in the treatment of negative symptoms in patients with chronic schizophrenia: a randomized double-blind placebo-controlled trial.

Antidepressant medication treatment has been associated with improvement in negative symptoms in patients with schizophrenia. In this study, we evaluated the efficacy of escitalopram for the treatment of negative symptoms in patients with schizophrenia. Under double-blind conditions, 40 patients with chronic schizophrenia were randomized to add-on treatment with escitalopram (up to 20mg) or placebo for 10weeks. The primary outcome measures were the scores on the Positive and Negative Syndrome Scale (PANSS)-negative subscale and the Social Functioning Scale (SFS). Secondary outcome measures included the Positive and Negative Syndrome Scale (PANSS)-total and positive scales, the Scale for Assessment of Negative Symptoms (SANS), the Clinical Global Impression Scale (CGI), the Hamilton Depression Rating Scale (HDRS) and the Abnormal Involuntary Movement Scale (AIMS). Of 40 patients, 36 completed the study and another 2 were excluded after 8weeks due to side effects. Thus, 38 patients (19 on both treatment arms) were considered in the efficacy analysis. The reduction in the PANSS negative subscale score was 5% for escitalopram and 10% for placebo (NS). There were no significant inter-group differences in primary and secondary endpoints. Escitalopram was well tolerated, but was not more effective than placebo in the treatment of negative symptoms in patients with chronic schizophrenia. Further work in this field is needed to determine whether some subgroups of patients with negative symptoms may nevertheless respond to antidepressant medications.