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Negative symptoms are the main cause of disability in schizophrenia, and they’ve long been considered untreatable or barely treatable. This study looked at the antidepressant vortioxetine (Trintellix) for them. Vortioxetine is the only antidepressant that has cognitive benefits that they FDA allowed mention of in the prescribing information. The independently sponsored study was conducted by Dr. Moazen-Zadeh and colleagues in Iran. Moazen-Zadeh E, Bayanati S, Ziafat K, Rezaei F, Mesgarpour B, Akhondzadeh S. Vortioxetine as adjunctive therapy to risperidone for treatment of patients with chronic schizophrenia: A randomised, double-blind, placebo-controlled clinical trial. J Psychopharmacol. 2020;34(5):506‐513. [Link]

Published On: 6/16/20

Duration: 1 minute, 51 seconds

Transcript: 

Negative symptoms are the main cause of disability in schizophrenia, and they’ve long been considered untreatable or barely treatable. This study looked at the antidepressant vortioxetine (Trintellix) for them. Vortioxetine is the only antidepressant that has cognitive benefits that they FDA allowed mention of in the prescribing information.

Among the study’s strengths, it was decent sized (78 patients, and 87% completion rate) and relatively long (2 months) for a pilot study, and randomised, double-blind, placebo-controlled.  All the patients were treated in the hospital after stabilization with risperidone.

The result: Vortioxetine improved negative symptoms with a large effect size of .95, and a decent interval around that from 0.5-1.5.  In contrast, there was no significant change in psychotic or depressive symptoms.

Bottom line: Vortioxetine joins a list of antidepressants with potential for negative symptoms in schizophrenia, incluing mirtazapine, trazodone, SSRIs, and duloxetine. We await to see if this effect, and this large effect size, is replicated. Exercise, yoga, and mindfulness also have positive trials for negative symptoms.

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