Neuroleptics plus benzodiazepines in schizophrenia

Forty-six schizophrenic or schizoaffective patients with operationally defined episodes of postpsychotic depression were assessed for previous histories of substance abuse. Thirty-five percent had histories of previous cannabis (marijuana) abuse. Additionally, 13% had also abused cocaine, 13% amphetamines, 11% hallucinogens, 4% sedatives, and 2% opiates. Patients with histories of substance abuse were younger and showed higher index ratings on a subscale of endogenous depressive features. These findings are considered in the context of a possible self-medication hypothesis of substance abuse. A history of substance abuse did not appear to be a contraindication to a therapeutic trial of adjunctive imipramine (Ciba Geigy Corp., Summit, NJ) for postpsychotic depression.