Adding antidepressants to antipsychotics in schizophrenia: do they work, for what, and are they safe?

Schizophrenia is not a taboo topic anymore. Some aspects of the illness, like hearing voices and delusions (‘positive symptoms’), are increasingly spoken and written about by laypeople. But ‘negative symptoms’ (lack of thought content, motivation, meaningful pleasure and sociability) and the predisposition for people with schizophrenia to get depressed, are still commonly under-appreciated.

Both these domains are often treated by adding an antidepressant to an already-prescribed antipsychotic, but the evidence for this isn’t as comprehensive as we’d like. There have been multiple small studies, but there is little consensus and some subsidiary questions (like whether antidepressants might worsen positive symptoms) remain unanswered. Fortunately for us, a team based in Munich have recently published a systematic review and meta-analysis in the American Journal of Psychiatry, to pull together all of the data in this broad area (Helfer et al, 2016).
This major new review examined the safety and efficacy of antidepressants added to antipsychotic drugs in the treatment of schizophrenia.


I was once on Clopixol depot and Wellbutrin. I drank Wellbutrin for a couple of months then I told my psychiatrist that I feel no affect from it. She said ok then and took me immediately off it. She later added Epitec to my meds and that really helped with my moods.

i like the effect of my Topamax on my mood. I cant take antidepressants they make me depressed, so I need a mood stabilizer Instead

I take Prozac. It helps a lot.

I’ve been on sertraline ‘Zoloft’ twice, both times it seemed to make me manic and psychotic

i was on antidepressants for years for no reason because they didnt know what i had

depends on the anti-depressant for me, celexa doesn’t help me, but Lexapro helped until the doctor took me off it then I felt depressed but a doctor added amitriptyline and that helped.

I’ve heard that prozac is very useful and helpful for depression ( ). It’s effective for someone with depression but not for someone with anxiety.