Efficacy of escitalopram combined with paliperidone in the treatment of schizophrenia with depressive symptoms
WANG Pu
GUAN Mingqin
ZHANG Xiaobin
Abstract：Objective To investigate the clinical efficacy and safety of escitalopram combined with paliperidone in the treatment of patients with schizophrenia and comorbid depressive symptoms.Methods A prospective randomized con-trolled trial was conducted.A total of 92 patients with schizophrenia and depressive symptoms admitted to Pingdingshan Psy-chiatric Hospital from May 2023 to February 2025 were enrolled and randomly divided into two groups using a random number table method.Ultimately,85 patients completed the study(42 cases in the study group and 43 cases in the control group).The control group was treated with paliperidone,while the study group received escitalopram oxalate in addition to the paliperidone regimen.Both groups were treated continuously for 12 weeks.Clinical symptoms,depression severity,cognitive and social function,and adverse reactions were assessed.Results After treatment,the Positive and Negative Syndrome Scale(PANSS)scores decreased in both groups compared to baseline.The PANSS scores in the study group at 8 weeks and 12 weeks of treat-ment((60.29±7.35)and(52.62±6.84)points)were lower than those in the control group((65.47±8.21)and(58.93±7.52)points)(t=3.062,4.044,both P<0.05).After treatment,the Hamilton Depression Rating Scale(HAMD)sores also decreased in both groups compared to baseline.The HAMD scores in the study group at 4,8,and 12 weeks of treatment((16.38±3.12),(13.57±2.68),and(11.04±2.15)points)were lower than those in the control group((18.25±3.04),(16.36±2.87),and(13.89±2.54)points)(t=2.799,4.630,5.577,all P<0.05).After treatment,the Montreal Cognitive Assessment(MoCA)scores improved in both groups.The study group had significantly higher MoCA scores than the control group at week 4((17.76±2.62)points vs(15.58±2.51)points),week 8((19.98±2.85)points vs(16.87±2.72)points),and week 12((22.32±3.05)points vs(17.65±2.81)points)(t=3.918,5.147,7.344,all P<0.05).The Personal and Social Performance(PSP)scale scores improved in both groups after treatment.The PSP scores in the study group at 4 weeks,8 weeks,and 12 weeks of treatment((48.63±3.52),(57.86±3.61),and(66.35±3.42)points)were higher than those in the control group((46.95±3.41),(54.76±3.68),and(60.18±3.79)points)(t=2.235,3.920,7.874,all P<0.05).The incidence of adverse reactions was 26.19%(11/42)in the study group and 23.26%(10/43)in the control group,with no statistically significant difference(χ2=0.098,P>0.05).Conclusion Compared to paliperidone monotherapy,the combination of escitalopram and paliperidone provides additional benefits for patients with schizophrenia and depressive symptoms.It can further improve patients'psychotic symptoms,depressive mood,cognitive function,and social functioning.Notably,it demonstrates a more significant trend of improvement in depression and cognition as early as 4 weeks into treatment,and maintains superior efficacy over 12 weeks,without increasing the risk of adverse reactions.
Keywords：escitaloprampaliperidoneschizophreniadepressive symptomscognitive function
Publication Date：2026-03-25
Online Publishing Date：2026-04-07(First online date of this platform, not the publication date of the document)
Pages：5( 358-362 )