title: Management of depressive symptoms in schizophrenia.
abstract: BACKGROUND
  Although depressive symptoms are a frequently occurring phenomenon in schizophrenia, effective treatments remain an area of clinical need.
  
  
  OBJECTIVE
  To assess the benefit of short-term treatment with the atypical antipsychotic asenapine versus placebo on depressive symptoms in patients with acute schizophrenia in an exacerbated state.
  
  
  METHODS
  Data were pooled from intent-to-treat (ITT) populations of three 6-week, randomized controlled studies with fixed doses of asenapine (ASE; n=427), olanzapine (OLA; n=82), risperidone (RIS; n=54), haloperidol (HAL; n=97), or placebo (PLA; n=254). Change from baseline Calgary Depression Scale for Schizophrenia (CDSS) total score and individual item scores were assessed at Day 21 and Day 42 in the total patient population (n=914), and in patients presenting with a CDSS total score of .6 at baseline (n=248). Mixed model repeated measures (MMRM) analyses were performed on patient data.
  
  
  RESULTS
  The observed change from baseline in CDSS total score was significantly larger with ASE.compared to PLA.at both Day 21 (p<0.05) and Day 42 (p<0.01) for the total patient population group, and at Day 21 (p<0.05) in patients with baseline CDSS total score .6. For both populations, there was a significant change from baseline in the CDSS depression item score with ASE.compared to PLA.at Day 21 (p<0.01, all patient population; p<0.05, patients with baseline CDSS .6), and at Day 42 (p<0.01) in the all patient population. Statistically significant changes from baseline, in favor of ASE versus PLA, were also observed in other individual CDSS item scores including hopelessness (p<0.05, Day 21, patients with baseline CDSS .6), self-depreciation (p<0.05, Day 42, all patient population), guilty ideas of reference (p<0.01, Day 42, all patient population), pathological guilt (p<0.01, Day 21, all patient population; p<0.05, Day 21 and Day 42, patients with baseline CDSS score .6), and observed depression (p<0.05, Day 21, all patient population).
  
  
  CONCLUSIONS
  ASE significantly improved a range of depressive symptoms in people with an acute exacerbation of schizophrenia, as measured by the CDSS. ASE may represent a beneficial treatment option for the management of depressive symptoms in patients with schizophrenia.
authors.affiliation: St Vincent's Hospital and The University of Melbourne, Victoria, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Castle
authors.affiliation: H. Lundbeck A/S, Valby, Denmark.
authors.forename: Jens-Kristian
authors.initials: JK
authors.lastname: Slott Jensen
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D001569:Benzodiazepines / Q000008:administration & dosage; D003865:Major Depressive Disorder / Q000188:drug therapy*; D003986:Dibenzocycloheptenes; D004311:Double-Blind Method; D005260:Female; D006220:Haloperidol / Q000008:administration & dosage; D006576:Heterocyclic Compounds, 4 or More Rings / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D018967:Risperidone / Q000008:administration & dosage; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D003986:Dibenzocycloheptenes; D006576:Heterocyclic Compounds, 4 or More Rings; D001569:Benzodiazepines; D006220:Haloperidol; C522667:asenapine; D018967:Risperidone; D000077152:Olanzapine
keywords: Antipsychotic; Asenapine; Depression; Schizophrenia