Buoli Massimiliano, Serati Marta, Ciappolino Valentina, Altamura A Carlo
a Department of Psychiatry , University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico , Milan , Italy.
Expert Opin Pharmacother. 2016 Jul;17(10):1375-85. doi: 10.1080/14656566.2016.1186646. Epub 2016 May 21.
The treatment of some psychopathological dimensions of schizophrenia (e.g. negative and depressive symptoms) is still challenging for the modest efficacy of atypical antipsychotics. Among pharmacological alternatives, augmentative Selective Serotonin Reuptake Inhibitors (SSRIs) to antipsychotics are frequently prescribed in clinical practice to improve negative/depressive symptoms of schizophrenia patients; however, the data about the efficacy of these molecules on negative, depressive and obsessive-compulsive symptoms of schizophrenia are contrasting.
Research using the main database sources has been conducted to obtain an overview of the use and efficacy of SSRIs in schizophrenia.
Data are too scanty to draw definitive recommendations. In a preliminary way, it can be said that available data do not show effectiveness of SSRIs on depressive symptoms of schizophrenia. Regarding negative symptoms, studies are contrasting, but paroxetine appears to be the most effective compound among SSRIs. Despite limited data, SSRIs appear to be useful for the treatment of obsessive-compulsive symptoms of schizophrenia, particularly fluvoxamine. Close clinical and pharmacological monitoring is needed in case of concomitant administration of antipsychotics and antidepressants for potential serious side effects and influence on plasma drug dosages.
对于精神分裂症的某些精神病理学维度（如阴性和抑郁症状）的治疗，非典型抗精神病药物疗效有限，仍具有挑战性。在药理学替代方法中，临床实践中常将抗精神病药物与增效选择性5-羟色胺再摄取抑制剂（SSRIs）联用，以改善精神分裂症患者的阴性/抑郁症状；然而，关于这些药物对精神分裂症阴性、抑郁和强迫症状疗效的数据存在矛盾。
已利用主要数据库来源进行研究，以全面了解SSRIs在精神分裂症中的使用情况和疗效。
数据过于稀少，无法得出明确建议。初步而言，可以说现有数据未显示SSRIs对精神分裂症抑郁症状有效。关于阴性症状，研究结果相互矛盾，但帕罗西汀似乎是SSRIs中最有效的化合物。尽管数据有限，但SSRIs似乎对治疗精神分裂症的强迫症状有用，尤其是氟伏沙明。在抗精神病药物和抗抑郁药物联合使用时，需要密切进行临床和药理学监测，以防出现潜在的严重副作用以及对血浆药物剂量的影响。
