Objective To explore the effect of ziprasidone combined with low dose of olanzapine in the treat-ment of schizophrenia with depressive symptoms,and its lipid metabolism.Methods According to the digital table, 108 schizophrenia patients with depressive symptoms were randomly divided into the two groups.The treatment group (n=54)was given starting doses of ziprasidone with 2.5mg/d,increased to 5 -10 mg/d for 1 week.And starting doses of olanzapine with 40mg/d,increased to 120 -160mg/d for 2 weeks.The control group (n=54)was given starting doses of olanzapine with 5mg/d,increased to 10-20mg/d for 2 weeks.The treatment course was 8 weeks.The PANSS score and HAMD score,indicators of obesity and blood lipid and adverse effect were observed.Results The PANSS score and HAMD score in the treatment group[(40.19 ±9.23)vs (59.29 ±10.14)]and the control group [(8.58 ±3.16)vs (12.19 ±4.04)]were significantly lower than those before treatment(t=9.41,4.91,6.51, 5.20,all P<0.05),and the scores in the treatment group were reduced more remarkably(t=5.11,3.01,all P<0.05).The waistline(83.45 ±5.29)cm,BMI(26.95 ±2.53)kg/m2,WHR(23.76 ±2.55)cm in the control group were all increased compared with those before treatment(t=5.14,3.18,all P<0.05)while the indicators[(23.76 ± 2.55)vs (23.76 ±2.55)]above improved more remarkably in the treatment group than those in the control group (t=5.38,4.53,all P<0.05).Compared with before treatment,the level of TC (6.54 ±0.86)mmol/L,TG(2.26 ± 0.83)mmol/L,LDL-C(3.94 ±0.43)mmol/L were increased remarkably,and HDL-C(1.02 ±0.18)mmol/L was reduced in the control group,TC(5.35 ±0.58)mmol/L in treatment group in the treatment group (t=4.20,3.27, 3.91,2.97,4.47,all P<0.05),while the indicators of blood lipid in the treatment group were better than those in the control group (t=3.18,3.01,2.76,2.87,all P<0.05).The TESS score in the treatment group(3.35 ± 0.57)point was lower than that in the control group(4.93 ±1.03)point (t=3.98,P<0.05).Conclusion It is effective and safe of combined with low dose of olanzapine in the treatment of schizophrenia with depressive symp-toms,which can contribute to effectively alleviate symptoms of depression with low effect on body weight and blood lip-id metabolism,less adverse reaction.