Evaluation of Typical Antipsychotic Augmentation with Sertraline in Reduction of Negative Symptoms in Patients with Schizophrenia in Ahvaz Golestan Hospital

Document Type : Original Article


1 Department of Psychiatry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Department of Psychiatry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.


Background and Objective: The aim of this study was to evaluate the efficacy of sertraline added to typical antipsychotics for the treatment of negative symptoms of patients with schizophrenia disorder.
Subjects and Methods: This study is a randomized double blind clinical trial. Thirty patients suffering from schizophrenia disorder (DSM-IV-TR) were selected randomly and devided into two groups. Depression was ruled out by Hamilton Depression Questionnaire. A group was given sertraline (50 mg/day) and the other group received placebo . The efficacy of sertraline and placebo in reduction of social withdrawal‚ emotional withdrawal‚ blunted affect and other negative symptoms was assessed weekly with PANSS scale during 6 weeks.
Results: Sertraline did not improve social withdrawal‚ emotional withdrawal‚ blunted affect and other negative symptoms in schizophrenia patients compared with placebo.
Conclusion: Adding sertraline on typical antipsychotic treatment does not seem to improve negative symptoms in patients with schizophrenia disorder.


1-Sadock BJ, Sadock VA, Ruiz P, eds. Kaplan & Sadock's comprehensive textbook of psychiatry. 9th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2009. P. 1432-556.
2-Sadock  BG, Sadock VA, eds. Kaplan & Sadock's synopsis of psychiatry: behavioral science/clinical psychiatry. 10th ed. Philadelphia: Wolter Kluwer/Lippincott, Williams & Wilkins; 2007. P. 123-6 .
3-Goff DC, Midha KK, Sarid-Segal O, Hubbard JW, Amico E. A placebo-controlled trial of fluoxetine added to neuroleptic in patients with schizophrenia. Psychopharmacology (Berl) 1995;117(4):417-23.
4-Shoja-Shafti S. [Effectiveness of citalopram alprazolam, clomipramine in amelioration of negative symptoms in schizopherenia]. J Rehabilitation 2003;3(12):42-9. [In Persian]
5-Melle I, Johannesen J, friis S, Haahr U, Joa I, Larsen TK, et al. Early detection of the first episode of schizophrenia and suicidal behavior. Am J Psychiatry 2006;163(5):800-4.
6-Gelder MG, Harrison PJ, Cowen Ph. Shorter oxford textbook of Psychiatry. 5th ed. Oxford: Oxford University Press; 2006. P. 267-306.
7-Silver H, Aharon N, Kaplan A. Add-on Fluvoxamine improves primary negative symptoms evidence for specificity from response analysis of individual symptoms. Schizophr  Bull 2003;29(3):541-6.
8-Erhart SM, Marder SR, Carpenter WT. Treatment of Schizophrenia Negative Symptoms: Future Prospects. Schizophr Bull 2006;32(2):234-7.
9-Shoja-Shafti S, Bakhtiari M. [Evaluation of prevalance of negetive symptoms in1% inpatients Schizophrenic ]. J Rehabilitation 2003;3(10):38-47. [In Persian]
10-Siris SG, Mason SE, Bermanzohn  PC, Alvir JM, McCorry TA. Adjunctive imipramine maintenance in post-psychotic depression/negative symptoms. Psychopharmacol Bull 1990;26(1):91-4.
11-Raedler TJ, Jahn H, Arlt J, Kiefer F, Schick M, Naber D, et al. Adjunctive use of reboxetine  in  schizophrenia. Eur Psychiatry 2004;19(6):366-9.
12-Salokangas RK, Saarijarvi S, Taiminen T, Kallioniemi H, Lehto H, Niemi H, et al. Citalopram as an adjuvant in chronic schizophrenia: a double-blind placebo-controlled study. Acta Psychiatr Scand 1996;94(3):175-80.
13-Taiminen TJ1, Syvälahti E, Saarijärvi S, Niemi H, Lehto H, Ahola V, et al. Citalopram as an adjuvant in   schizophrenia: Furthur evidence for a serotonergic dimension in schizophrenia. Int Clin Psychopharmacol1997;12(1):31-5.
14-Thakore JH, Berti C, Dinan TG. An open trial of adjunctive sertraline in the treatment of chronic schizophrenia. Acta Pychiatr Scand 1996;94(3):194-7.
15-Lee MS, Kim YK, Lee SK, Suh KY. A double-blind study of adjunctive sertraline in haloperidol-stabilized patients with chronic schizophrenia. J Clin Psychopharmacol 1998;18(5):399-403 .
16-Sardarpur Sh, Arbabi M. Efficacy of naltroxan in treatment of  schizophrenia.A double- blind, placebo-controlled clinical trial. Iran Clin Psychiatr J 2006;12(1):49-54.[In Persian]
17-Phayezi B. Efficacy of selgilin in schizophrenia negative symptoms.A double- blind study. Iran Clin Psychiatr 2008;14(2):131-139. [In Persian]
18-Maleki M, Javidi Z, Kiafar B, Saadatian V, Saremi AK. Depression in vitiligo patients. Q J Fundamentals Mental Health 2005;7(25-26):5-11. [In Persian]
19-Sepehri AA, Potvin S, Elie R, Stip E. Selective serotonin reuptake inhibitor (SSRI) add-on therapy for the negative symptoms of schizophrenia: a meta- analysis. J Clin Psychiatr 2007;68(4):604-10.
20-Takahashi H, Sugita T, Higuchi H, Shimizu T. Fluvoxamine augmentation in risperidone-resistant schizophrenia: an open trial. Hum Psychopharmacol 2002;17(2):95-8.
21-Silver H, Shmugliakov N. Augmentation with fluvoxamine but not maprotiline improves negative  symptoms in treated schizophrenia: evidence for a specific serotonergic effect from a double-blind study. J Clin Psychopharmacol 1998;18(3):208-11.
22-Lee MS, Han CS, You YW, Kim SH. Co-adminstration of sertraline and haloperidol. Psychiatry Clin Neurosci 1998;52:S193-8.
23-Singh SP, Singh V, Kar N, Chan K. Efficacy of antidepressants in treating the negative symptoms of chronic schizophrenia: meta- analysis. Br J Psychiatry 2010;197(3):174-9.
24-Erhart SM, Marder SR, Carpenter WT. Treatment of schizophrenia negative symptoms: Future prospects. Schizophr Bull 2006;32(2):234-7.
25-Silver H. Selective serotonin reuptake inhibitor augmentation in the treatment  of  negative symptoms of schizophrenia. Int Clin Psychopharmacol 2003;18(6):305-313. 
26-Nazari Nasab M, Khajeddin N, Shanesaz AA, Pezeshki A. [Evaluation of typical antipsychotic augmentation  with citalopram in reduction of negative symptoms in inpatient  schizophrenia in Ahvaz  Golestan Hospital]. Jundishapur Sci Med J 2012;11(4):439-48. [In Persian]