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KMID : 1009020070050010014
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Clinical Psychopharmacology and Neuroscience
2007 Volume.5 No. 1 p.14 ~ p.18
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Depression and Suicide Risk in Patients with Schizophrenia during the Treatment by Second Generation Antipsychotic Agents: A Mini-Review
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Kaneda Yasuhiro
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Abstract
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This mini-review focuses on the depression and suicide risk in patients with schizophrenia during the treatment by second generation antipsychotic drugs. Regarding depressive symptoms and depressive illness in schizophrenia, several studies have found a relationship between negative or positive symptoms and depressive symptoms. Also,“revealed depression”,“akinetic depression”, or“pharmacogenic depression” is reported to explain the presence of depression in schizophrenia. There are several good reasons to consider that second generation antipsychotic drugs may prove to have at least somewhat superior effects on depression in schizophrenia than first generation antipsychotic drugs: their relatively weak blockade at D2 receptors, minimal serum prolactin elevations, and minimal extrapyramidal symptoms. Regarding suicide in schizophrenia, depression is one of the important factors for suicide. Second generation antipsychotic drugs particularly clozapine are thought to be effective for suicide in schizophrenia, via several proposed mechanisms including an antidepressant effect. Over all, second generation antipsychotic drugs are considered to be effective for both depression and suicide in schizophrenia. However, since patients would have strong psychological reactions to their symptom improvement, which would make a maladaptive or adaptive response, it should be noted that changes in awareness associated with treatment be carefully monitored regardless of medications we choose.
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KEYWORD
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Antipsychotic agents, Depressive disorder, Schizophrenia, Suici de.
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