A certain degree of depressive symptoms is common in schizophrenic patients. The assessment and treatment of depressive symptoms in schizophrenia is clinically challenging.

We conducted a cross-sectional study to investigate the depressive dimension of schizophrenic patients.

The aim was to evaluate the effect of pharmacotherapy on depressive symptomatology.

Thirty-four outpatients (18-65 years old) with stable schizophrenia in monotherapy with FGAs or SGAs. We evaluated: depressive symptoms with Calgary Depression Scale for Schizophrenia; positive and negative symptoms (with Positive and Negative Symptom Scale); neurocognition (with Matrics Cognitive Consensus Battery); social cognition (with Facial Emotional Identification Test); social functioning (with Personal and Social Performance Scale and with UCSD Performance-based Skills Assessment). Collected data underwent statistical analyses.

A SGAs therapy was associated with: lower depressive symptoms (mean SGAs group=4.0; mean FGAs group=7.86, P<0.05); lower mean positive symptoms (mean SGAs group=12.65; mean FGAs group=17.43, P<0.05); lower negative symptoms (mean SGAs group=21.35; mean FGAs group=29.07, P<0.05); lower scores on the PANSS-total (mean SGAs group=71.05; mean FGAs group=91.86, P<0.01). After correction for multiple variables, the SGAs group still had significantly lower values towards the FGAs group (P<0.05).

Our study support the notion that switch from a FGA to a SGA could be a relatively simple first-step for the treatment of this condition. Atypical antipsychotics might exercise antidepressant effects with different potential mechanism including: remission of a FGA-induced depression and action on of 5-hydroxytryptamine, dopamine [other than postsynaptic D2], and α1-noradrenergic receptor sites.