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Review: Adding SSRIs to antipsychotics does not improve negative symptoms in people with schizophrenia

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Sepehry AA, Potvin S, Elie R, et al. Selective serotonin reuptake inhibitor (SSRI) add-on therapy for the negative symptoms of schizophrenia: a meta-analysis. J Clin Psychiatry 2007;68:604–10.

METHODS

Embedded ImageDesign:

Systematic review with meta-analysis.

Embedded ImageData sources:

PsycINFO, MEDLINE (1967–2005), Current Contents (1993–2005), hand searching of reference lists, and contact with pharmaceutical companies.

Embedded ImageStudy selection and analysis:

The review included randomised, placebo-controlled, double-blind trials comparing the addition of SSRIs to antipsychotics versus adding placebo in people with schizophrenia-spectrum disorder. Main exclusions: comorbid obsessive-compulsive disorder; studies of monoamine oxidase inhibitors, tricyclic, dual action, or atypical antidepressants (for example, bupropion); incomplete or unavailable data; crossover RCTs. Data were extracted by two reviewers, with disagreement resolved by consensus. Hedges’ g effect sizes (which adjust for sample size) were calculated using a random effects model. Heterogeneity was assessed using the Q statistic, with the threshold for significance set at p<0.1. In addition, …

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