Implications of the efficacy of thiothixene and a chlorpromazine-imipramine combination for depression in schizophrenia.

The ineffectiveness of antidepressants, and the effectiveness of neuroleptics alone, in the treatment of depressed schizophrenic patients is evidence that a pharmacologically definable depression cannot be demonstrated in schizophrenia. The author reports findings from a double-blind 1-month study of 52 anergic and depressed schizophrenic patients given thiothixene-placebo or chlorpromazine-imipramine. These findings support DSM-III, which does not diagnose intercurrent, secondary depression in the presence of schizophrenia. Consistent with most of the clinical literature, this study also supports the use of a single neuroleptic rather than neuroleptic-antidepressant combinations to treat depressive symptoms secondary to schizophrenia.