A surreal brain illustration symbolizes the complexities of treating depression in schizophrenia.

Schizophrenia and Depression: Do Antidepressants Really Help?

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Theo Raines in Health & Wellness December 2025 • 4 min read.

"A new analysis dives into whether antidepressants ease depression in schizophrenia, offering hope but highlighting the need for better research."


Depression is a frequent and serious issue for individuals living with schizophrenia, significantly impacting their overall well-being and increasing the risk of suicide. Managing this depression effectively is crucial, yet clear guidelines on the best treatments are lacking, leaving clinicians to navigate complex decisions with limited specific guidance.

A common approach is to prescribe antidepressants, but questions remain about how well these medications actually work for people with schizophrenia. A recent systematic review and meta-analysis, published in "The British Journal of Psychiatry", sought to synthesize the available evidence and determine the effectiveness of antidepressants in treating depression in schizophrenia.

This article explores the findings of this review, providing insights into the potential benefits and limitations of using antidepressants for depression in schizophrenia. We'll break down the research, making it easy to understand and highlighting what it means for individuals, families, and healthcare professionals.

Antidepressants for Schizophrenia: Promising Results?

A surreal brain illustration symbolizes the complexities of treating depression in schizophrenia.

The study, led by Angharad Gregory, Pavan Mallikarjun, and Rachel Upthegrove, rigorously examined 26 trials to assess the impact of antidepressants on depression in schizophrenia. Their meta-analysis revealed a potentially significant finding: antidepressants may indeed offer some relief from depression for individuals with schizophrenia.

Specifically, the analysis showed a significant risk difference favoring antidepressant treatment. This means that individuals receiving antidepressants were more likely to experience a positive response compared to those receiving a placebo or standard care. The researchers calculated a number needed to treat (NNT) of 5, suggesting that for every five people treated with antidepressants, one additional person would benefit.

  • Positive Signal: The initial meta-analysis indicated a benefit from antidepressant treatment.
  • Specific Tools Matter: Larger effects were seen in studies using tools designed to assess depression in schizophrenia, like the Calgary Depression Scale for Schizophrenia (CDSS).
  • Sensitivity Analysis Caution: When stricter statistical analyses were applied, the significant improvement wasn't always maintained, suggesting the initial findings should be interpreted cautiously.
However, these positive signals were tempered by the study's other findings. When the researchers performed a sensitivity analysis (a process of re-analyzing the data with slightly different assumptions), the statistically significant improvement in depression scores disappeared. This raises questions about the robustness of the initial findings and highlights the need for further investigation.

What This Means for Treatment Approaches

The study's findings offer a mixed message. On one hand, they suggest that antidepressants may be a useful tool in managing depression for people with schizophrenia. On the other hand, the limitations of the existing research emphasize the need for caution and further investigation.

Clinicians should carefully consider the individual needs of each patient when making treatment decisions. The use of depression assessment tools specifically designed for schizophrenia, such as the CDSS, may provide a more accurate picture of a patient's symptoms. Furthermore, a thorough discussion of the potential benefits and risks of antidepressant treatment is essential.

Ultimately, more research is needed to determine the true effectiveness of antidepressants for depression in schizophrenia. Future studies should prioritize rigorous methodology, larger sample sizes, and the use of standardized assessment tools. This will help to provide clinicians with the evidence they need to make informed treatment decisions and improve the lives of individuals living with both schizophrenia and depression.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1192/bjp.bp.116.190520, Alternate LINK

Title: Treatment Of Depression In Schizophrenia: Systematic Review And Meta-Analysis

Subject: Psychiatry and Mental health

Journal: British Journal of Psychiatry

Publisher: Royal College of Psychiatrists

Authors: Angharad Gregory, Pavan Mallikarjun, Rachel Upthegrove

Published: 2017-10-01

Everything You Need To Know

1

Why is depression a concern for individuals with schizophrenia?

Depression is a significant problem for people with schizophrenia, often affecting their overall well-being and potentially increasing the risk of suicide. Effective management of depression is crucial for those living with schizophrenia.

2

What did the research team do to investigate the use of antidepressants?

The study, led by Angharad Gregory, Pavan Mallikarjun, and Rachel Upthegrove, conducted a meta-analysis that examined 26 trials to assess the impact of antidepressants on depression in schizophrenia. The meta-analysis found a positive signal, suggesting that those receiving antidepressants were more likely to experience a positive response compared to those receiving a placebo or standard care.

3

How did the tools used to assess depression affect the study results?

The research indicated that the effectiveness of antidepressants was more noticeable in studies that used tools like the Calgary Depression Scale for Schizophrenia (CDSS). This suggests that the way depression is measured in studies can impact the results.

4

What were the limitations of the study findings?

A sensitivity analysis was performed, re-analyzing the data with different assumptions. It revealed that the statistically significant improvement in depression scores wasn't consistently maintained. This suggests that the initial positive findings should be interpreted cautiously, and further investigation is needed to confirm the benefits of antidepressants.

5

What do the findings of the study mean for the treatment of depression in individuals with schizophrenia?

The findings suggest that antidepressants might be helpful in managing depression for people with schizophrenia. However, the study also highlights limitations in the research, emphasizing the need for caution and further investigation to fully understand the benefits and risks of using antidepressants in this context. More research is needed to establish clear guidelines for treatment.

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