Citalopram Augmentation in Older Schizophrenia Patients

描述：精神分裂症中的抑郁症状，虽然非常普遍， 通常是慢性的和致残的，仍然相对较少被研究。抗抑郁药 在临床实践中通常用于治疗各种症状 精神分裂症患者。尽管一些文献描述了这种治疗方法 主要是患有精神分裂症的年轻人的综合征候群抑郁， 可用于指导治疗的研究相对较少。 这一人群中的亚综合征抑郁症状，尤其是中年人 以及患有精神分裂症的老年人。老年精神分裂症患者则不同 在几个重要方面与他们的年轻同行不同，比如拥有 更大的身体共病、认知障碍和更高的侧面风险 效果。这项研究将评估抗抑郁药的有效性和安全性。 (西酞普兰)与安慰剂强化非典型抗精神病药物治疗的比较 中老年患者的亚证型、残留抑郁症状 患有精神分裂症。该协作、两个站点(加州大学旧金山分校 迭戈和辛辛那提大学)，一项为期五年的研究假设 西酞普兰对抗精神病药物的强化作用将比 安慰剂强化治疗在减轻抑郁症状和增强 功能和生活质量。我们建议招收240名学生 55岁或以上并有汉密尔顿综合症的精神分裂症门诊患者 抑郁评定量表17个条目得分在10分或以上，变为随机化、 双盲、灵活剂量、安慰剂对照研究。在稳定之后 至少四周服用非典型抗精神病药物(利培酮或 奥氮平)，有残余抑郁症状的患者(HAM-D评分为10 或更高)将随机接受以下干预之一：非典型干预 抗精神病药物(利培酮或奥氮平)加西酞普兰；或非典型 抗精神病药物(利培酮或奥氮平)加安慰剂。双盲人 疗程为三个月，随访评估三个月 后来。每周将对抑郁症状和副作用进行评估 第一个月，第二个月每两周一次，第三个月结束时再次 月份。此外，我们还将评估认知、运动和日常功能， 生活质量，以及整个研究期间的用药依从性。是独一无二的 提案中，我们将使用基于绩效的结果衡量标准来评估现实世界 功能能力。通过提供经验证据来指导治疗 精神分裂症患者的抑郁症状，这项研究可能 减少残疾对公共卫生的重大影响 提高这一患者群体的生活质量。

DESCRIPTION: Depressive symptoms in schizophrenia, while highly prevalent, often chronic, and disabling, remain relatively understudied. Antidepressants are commonly used in clinical practice to treat a variety of symptoms in patients with schizophrenia. Although some literature describes the treatment of syndromal depression in primarily young adults with schizophrenia, comparatively little research is available to guide the treatment of subsyndromal depressive symptoms in this population, especially in middle-aged and older adults with schizophrenia. Older people with schizophrenia differ from their younger counterparts in several important ways, such as having greater physical comorbidity, cognitive impairment, and a higher risk of side effects. This study will evaluate the efficacy and safety of antidepressant (citalopram) versus placebo augmentation of atypical antipsychotics to treat subsyndromal, residual depressive symptoms in middle-aged and older patients with schizophrenia. This collaborative, two-site (University of California, San Diego and University of Cincinnati), five-year study hypothesizes that citalopram augmentation of antipsychotic medication will be more effective than augmentation with placebo at reducing depressive symptoms and enhancing functioning and quality of life. We propose to enroll a total of 240 outpatients with schizophrenia, who are 55 years or older and have a Hamilton Depression Rating Scale 17-item score of ten or greater, into a randomized, double-blind, flexible-dose, placebo-controlled study. After stabilization for at least four weeks on an atypical antipsychotic agent (either risperidone or olanzapine), patients who have residual depressive symptoms (HAM-D score of ten or greater) will be randomized to one of the following interventions: atypical antipsychotic (risperidone or olanzapine) plus citalopram; or atypical antipsychotic (risperidone or olanzapine) plus placebo. The double-blind treatment period will be three months with a follow-up assessment three months later. Depressive symptoms and side effects will be assessed weekly for the first month, biweekly for the second month, and again at the end of the third month. In addition, we will evaluate cognitive, motor and daily functioning, quality of life, and medication adherence throughout the study. Unique to this proposal, we will use performance-based outcome measures to assess real-world functional capacities. By providing empirical evidence to guide treatment of depressive symptoms in patients with schizophrenia, the study could have significant public health implications for the reduction of disability and the enhancement of quality of life in this patient population.