Antidepressants, Antipsychotics and Cognitive Remediation in Schizophrenia By Prof Bernhard Baune

Posted on: July 16, 2019
Last Updated: August 19, 2020

Prof Bernhard Baune, Ph.D., MD, MPH, FRANZCP, holds the Cato Chair and is Head of Psychiatry at the  University of Melbourne. In 2011, he was appointed as Chair of Psychiatry and Head of Discipline of Psychiatry at the University of Adelaide. Under his leadership, psychiatry research at the University of Adelaide gained international recognition for excellence in neuroimmunology and genomics of mental disorders, and for innovation in molecular and clinical underpinnings of personalized psychiatry. Prof Baune has authored or co-authored 204  peer-reviewed publications and 14 book chapters. 

Author Quotes 

It is relevant to say that anti-depressants have a more broad effect, potentially, if added to antipsychotic medication.

The other really core business in treating or improving outcomes in schizophrenia is looking at cognitive functioning.

Cognitive remediation is a treatment which we use also in anxiety disorder and use in depression; it’s a generalised concept of helping to improve specific cognitive functions by training on cognitive tasks.

Summary and slides  

Continuing to look at common co-morbidities in schizophrenia, Professor Baune describes a meta-analysis performed with data from >3000 patients. Compared with controls, addon anti-depressant treatment was found to improve various outcomes, including depressive symptoms, positive and negative symptoms and quality of life. When baseline symptoms were worse, the impact of treatment was greater. Agomelatine administered as an add-on treatment was found to be efficacious in treating depressive symptoms and was well tolerated. 

Moving on, he then highlights studies in which addon treatment with antipsychotic drugs, including lurasidone and quetiapine, also significantly improved depressive symptoms. 

Professor Baune remarks on the importance of treating cognitive impairment, and recent research into available treatment options. 

The association between the use of antipsychotic medication and global cognition is then detailed. 

Finally, Professor Baune discusses the confounding factors which influence outcomes.

Take-home Points  

  • Add-on anti-depressants improve depressive symptoms.  
  • Some antipsychotics can induce depressive symptoms, but with good treatment choices, depressive symptoms can be improved. 
  • Alongside long-term antipsychotic use, many confounding factors influence global cognition outcomes. 

Quiz


Learn more

  1. Patient Selection and Holistic Treatment in Schizophrenia By Prof Bernhard Baune
  2. Management of Metabolic Risk Associated With Antipsychotics By Prof Bernhard Baune
  3. Management of Schizophrenia and Common Comorbidities by Prof Bernhard Baune
  4. Antipsychotics and the Link Between Metabolic Syndrome and Schizophrenia By Prof Bernhard Baune