Fast Five Quiz: Schizophrenia Comorbidities

Stephen Soreff, MD

Disclosures

April 22, 2021

Anxiety may precede the onset of schizophrenia by several years. Treatment decisions should be tailored to the patient's source of anxiety.

Many patients with schizophrenia have symptoms of anxiety, but it is unclear whether anxiety occurs independently or as part of the disease. Such symptoms may also be a reaction to schizophrenia or a complication of treatment. For example, patients may experience adverse effects of medications, such as akathisia. However, these patients might interpret such a side effect as anxiety.

Following treatment recommendations for primary anxiety disorder would be reasonable in many cases; however, fluvoxamine and other SSRIs should be used judiciously in patients receiving clozapine because these drugs have been shown to raise clozapine blood levels. Benzodiazepines may be effective in some cases, but their risks should be considered as well. Benzodiazepines use can lead to addiction and should be given cautiously.

Although only limited data are available on treatment of comorbid anxiety disorders, antipsychotics usually relieve anxiety caused by an acute psychotic episode.

Learn more about complications of schizophrenia.

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