Antidepressant for substance-abusing schizophrenic patients: a minireview.

1. Substance abuse and post-psychotic depression are both frequently encountered concomitants of schizophrenia. 2. Substance abuse may be associated with depression-like symptomatology in the course of schizophrenia, and patients may attempt to self-medicate these symptoms with substances of abuse. 3. Antidepressant medication has been found to be a useful adjunct to treatment in at least some cases of substance abuse and some cases of post-psychotic depression. 4. Preliminary evidence exists suggesting that adjunctive antidepressant medication, added to a neuroleptic, may be useful for at least some stable dysphoric substance-abusing schizophrenic patients. 5. It is important to attempt to rule out even subtle neuroleptic-induced akinesia in such patients with a vigorous trial of antiparkinsonian medication.