Selective Serotonin Reuptake Inhibitor Add-On Therapy for the Negative Symptoms of Schizophrenia

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Sir: I read with interest the recent meta-analysis by Sepehryet al.¹ of selective serotonin reuptake inhibitor (SSRI) add-ontherapy for negative symptoms of schizophrenia and am concernedthat their negative conclusion largely reflects methodologicallimitations.The small number and heterogeneity of available studiesmake meta-analytic analyses at this time particularly vulnerableto confounds.² Further, optimal use was not made of availablestudies: all participants in our original study³ received typicalantipsychotics (the only ones available then), a fact easily clarified,and thus were eligible for subanalyses of that group.’ ‹