scholarly journals Tackling Negative Symptoms of Schizophrenia with Memantine

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Antonios Paraschakis
Keyword(s):  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Chronic Schizophrenia ◽  
Glutamate Excitotoxicity ◽  
Positive Symptoms ◽  
Glutamate Receptor Antagonist ◽  
Residual Symptoms ◽  
Full Remission ◽  
Long Acting ◽  
Affective Flattening

We present a case of a 52-year-old male patient suffering from chronic schizophrenia stabilized on risperidone long-acting injection (37,5 mg/2 weeks) and biperiden 4 mg/day. Residual symptoms are affective flattening, alogia, avolition, and asociality. Memantine 10 mg/day was added. After 1.5 months, the patient spontaneously referred to “feel better being in company of my relatives.” The following scales have been completed: the Scale for the Assessment of Negative Symptoms (96), the Scale for the Assessment of Positive Symptoms (3), the Mini Mental Scale Examination (26), and the Calgary Depression for Schizophrenia Scale (2). Memantine was increased to 20 mg/day and biperiden was decreased to 2 mg/day. Two months later, apathy and asociality considerably improved and affective flattening, alogia, and attention slightly got better (SANS 76, SAPS 1, MMSE 26, and CDSS 1). After two more months, the improvement continued in the same domains (SANS: 70, SAPS: 1 MMSE: 27, and CDSS: 1). Positive symptoms remained in full remission. It has been hypothesized that one of the causes of schizophrenia is glutamate excitotoxicity. Memantine, a glutamate receptor antagonist, could possibly ameliorate schizophrenia symptoms, the negative ones among them, used as add-on therapy to atypical antipsychotics. Memantine could be of potential help in schizophrenia patients with severe residual negative symptoms.

ARE SOME TYPES OF PSYCHOTIC SYMPTOMS MORE RESPONSIVE TO COGNITIVE-BEHAVIOUR THERAPY?

2001 ◽  
Vol 29 (1) ◽  
pp. 45-55 ◽  
Author(s):  
Nicholas Tarrier ◽  
Caroline Kinney ◽  
Ellis McCarthy ◽  
Anja Wittkowski ◽  
Lawrence Yusupoff ◽  
...  
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Negative Symptoms ◽  
Controlled Trial ◽  
Chronic Schizophrenia ◽  
Routine Care ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Supportive Counselling

Results are presented from a randomized controlled trial indicating which psychotic symptoms respond to cognitive behaviour therapy. The aim of the study was to investigate whether different types of psychotic symptoms are more or less responsive to cognitive-behaviour therapy compared to treatment received by control groups. Seventy-two patients suffering from chronic schizophrenia who experienced persistent positive psychotic symptoms were assessed at baseline and randomized to either cognitive-behaviour therapy and routine care, supportive counselling and routine care, or routine care alone and were re-assessed after 3 months of treatment (post-treatment). Independent and blind assessment of outcome indicated delusions significantly improved with both cognitive behaviour therapy and supportive counselling compared to routine care. Hallucinations significantly decreased with cognitive-behaviour therapy compared to supportive counselling. There was no difference in the percentage change of hallucinations compared to delusions in patients treated by cognitive behaviour therapy. There was little change in measures of affective symptoms but there was no evidence that a reduction in positive symptoms was associated with an increase in depres sion. In fact, a reduction in positive symptoms was positively correlated with a reduction in depression. There were significant differences in the reductions in thought disorder and negative symptoms with an advantage of cognitive-behaviour therapy compared to routine care.

Tardive Dyskinesia and Type II Schizophrenia

1992 ◽  
Vol 160 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Elizabeth J. B. Davis ◽  
Milind Borde ◽  
L. N. Sharma
Keyword(s):  
Cognitive Impairment ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Thought Disorder ◽  
Control Group ◽  
Positive Symptoms ◽  
Type Ii ◽  
Formal Thought Disorder ◽  
Schizophrenic Patients ◽  
Male Patients

Cognitive impairment, negative and positive symptoms, primitive release reflexes, and age/temporal disorientation were assessed in 20 male patients meeting the DSM–III–R criteria for chronic schizophrenia and Schooler & Kane's criteria for TD. The control group comprised 20 age-matched male chronic schizophrenic patients without TD. Significant associations were found between TD, cognitive impairment, some negative symptoms, and formal thought disorder. These associations were independent of other illness and treatment variables. The severity of TD correlated significantly with that of cognitive impairment.

Theory of mind in the early course of schizophrenia: stability, symptom and neurocognitive correlates, and relationship with functioning

2015 ◽  
Vol 45 (10) ◽  
pp. 2031-2043 ◽  
Author(s):  
J. Ventura ◽  
A. Ered ◽  
D. Gretchen-Doorly ◽  
K. L. Subotnik ◽  
W. P. Horan ◽  
...  
Keyword(s):  
Theory Of Mind ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
First Episode ◽  
Positive Symptoms ◽  
Healthy Controls ◽  
Role Functioning ◽  
Recent Onset ◽  
Early Course ◽  
The Relationship

BackgroundNumerous studies have reported links between theory of mind (ToM) deficits, neurocognition and negative symptoms with functional outcome in chronic schizophrenia patients. Although the ToM deficit has been observed in first-episode patients, fewer studies have addressed ToM as a possible trait marker, neurocognitive and symptom correlations longitudinally, and associations with later functioning.MethodRecent-onset schizophrenia patients (n = 77) were assessed at baseline after reaching medication stabilization, and again at 6 months (n = 48). Healthy controls (n = 21) were screened, and demographically comparable with the patients. ToM was assessed with a Social Animations Task (SAT), in which the participants’ descriptions of scenes depicting abstract visual stimuli ‘interacting’ in three conditions (ToM, goal directed and random) were rated for degree of intentionality attributed to the figures and for appropriateness. Neurocognition, symptoms and role functioning were also assessed.ResultsOn the SAT, patients had lower scores than controls for both intentionality (p < 0.01) and appropriateness (p < 0.01) during the ToM condition, at baseline and 6 months. The ToM deficit was stable and present even in remitted patients. Analyses at baseline and 6 months indicated that for patients, ToM intentionality and appropriateness were significantly correlated with neurocognition, negative symptoms and role functioning. The relationship between ToM and role functioning was mediated by negative symptoms.ConclusionsThe ToM deficit was found in recent-onset schizophrenia patients and appears to be moderately trait-like. ToM is also moderately correlated with neurocognition, negative and positive symptoms, and role functioning. ToM appears to influence negative symptoms which in turn makes an impact on role functioning.

Current use of atypical antipsychotics

2002 ◽  
Vol 17 (S4) ◽  
pp. 377s-384s ◽  
Author(s):  
F. Müller-Spahn
Keyword(s):  
Side Effects ◽  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Term Treatment ◽  
Dopamine Neurons ◽  
Positive Symptoms ◽  
Onset Of Action ◽  
Conventional Antipsychotics ◽  
Long Term Treatment ◽  
Insufficient Response

SummaryIn terms of the phenomenology of schizophrenia, there are four targets for drug treatments: positive symptoms, negative symptoms, affective dysfunction, and cognitive dysfunction. Because of the side-effects of both conventional antipsychotics and the new atypicals, there still is a need to search for better-tolerated antipsychotics. Conventional antipsychotics have two principal limitations: 30–40% of patients have an insufficient response to them, and they have a large variety of adverse effects. Side-effects will reduce patients’ compliance with treatment, as well as their immediate quality of life, and may therefore unfavorably affect rehabilitation. Four principal features differentiate atypical from conventional antipsychotics, yet have not been established for all atypicals: fewer extrapyramidal side-effects, greater efficacy in the treatment of negative symptoms, specific pharmacological receptor binding profiles, and greater selective effect on the mesolimbic dopamine neurons than on nigrostriatal neurons. The pharmacological profile of amisulpride is completely different to that of other atypical antipsychotics. It has a high selectivity for D2 and D3 dopamine receptors, and thus would be expected to be devoid of unwanted side-effects associated with action on other neurotransmitter systems. It acts preferentially on the mesocortical and mesolimbic systems. It has an earlier onset of action than haloperidol. Amisulpride is a compound with a dual mode of action. At low doses it blocks presynaptic dopamine autoreceptors, inducing an increased dopaminergic neurotransmission, and at high doses it blocks postsynaptic dopaminergic activity. It is at least as effective as haloperidol, flupenthixol, and risperidone in controlling positive symptoms, as well as having efficacy for negative symptoms. It has less propensity to induce weight gain than do other atypical antipsychotics. For the 60–80% of patients with schizophrenia who require long-term treatment, drug tolerability is crucially important, as it will improve compliance, and therefore reduce relapse rate.

Pharmacoeconomics of long-acting atypical antipsychotics for acutely relapsed chronic schizophrenia in Finland

2015 ◽  
Vol 19 (2) ◽  
pp. 121-130 ◽  
Author(s):  
Thomas R. Einarson ◽  
Hanna Pudas ◽  
Pushpendra Goswami ◽  
Kristel van Impe ◽  
Basil G. Bereza
Keyword(s):  
Atypical Antipsychotics ◽  
Chronic Schizophrenia ◽  
Long Acting

scholarly journals Atypical antipsychotics and the negative symptoms of schizophrenia

1998 ◽  
Vol 4 (1) ◽  
pp. 53-61 ◽  
Author(s):  
David J. King
Keyword(s):  
Nervous System ◽  
Antipsychotic Medication ◽  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Genetic Factors ◽  
Cortical Atrophy ◽  
Positive Symptoms ◽  
Type I ◽  
Type Ii ◽  
Positive And Negative Symptoms

The concept of positive and negative symptoms in schizophrenia can be traced back to Hughlings Jackson (1889) who taught that disease does not create, it sets free, and accordingly positive symptoms could be seen as ‘release’ phenomena resulting from ‘dissolution’ of the highest cerebral centres of the nervous system. Crow (1980) revived the dichotomy and proposed a Type I syndrome, characterised by positive symptoms, and a Type II syndrome, characterised by negative symptoms. He thought the latter was due to cortical atrophy and responded poorly to antipsychotic medication. In their review of the distinction, Walker & Lewine (1988) found a stronger relationship between premorbid dysfunction and negative symptoms than with positive symptoms. They also found there was a stronger influence of genetic factors on negative symptoms than positive symptoms.

Psychotic-like experiences and depressive symptoms in a community sample of adolescents

2011 ◽  
Vol 26 (6) ◽  
pp. 396-401 ◽  
Author(s):  
M. Barragan ◽  
K.R. Laurens ◽  
J.B. Navarro ◽  
J.E. Obiols
Keyword(s):  
Depressive Symptoms ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Social Withdrawal ◽  
Community Sample ◽  
Principal Component ◽  
Positive Symptoms ◽  
Principal Component Factor Analysis ◽  
Positive Experiences ◽  
Affective Flattening

AbstractPurposeStudies of psychotic-like experiences (PLEs) within community samples of adolescents have explored predominantly positive experiences. There is a paucity of research examining the prevalence and correlates of negative PLEs, and whether particular subtypes of negative PLEs can be identified among the general population of adolescents. This study examined the association of both positive and negative PLEs with depressive symptoms, including detailed analysis of subtypes of positive and negative psychosis dimensions.MethodA community sample of 777 adolescents (50.9% girls: mean age 14.4 years) completed a questionnaire assessing positive and negative PLEs and depressive symptoms.ResultsPrincipal component factor analysis identified four factors of positive symptoms (persecutory ideation, grandiose thinking, first-rank/hallucinatory experiences and self-referential thinking), and three factors of negative symptoms (social withdrawal, affective flattening, and avolition). Depressive symptoms were associated positively with persecutory ideation, first-rank/hallucinatory experiences, social withdrawal, and avolition, whereas grandiose thinking related negatively with depressive symptoms. Neither self-referential thinking nor affective flattening related to self-reported depression.ConclusionsThese findings support the view that not all types of positive and negative PLEs in adolescence are associated with depression and, therefore, they may not confer the same vulnerability for psychotic disorders.

scholarly journals Evaluation of paliperidone on social function in patients with chronic schizophrenia

2018 ◽  
Vol 31 (2) ◽  
pp. e000011
Author(s):  
Yan Gu ◽  
Hong Peng ◽  
Jingjing Dai ◽  
Hui Gao ◽  
Xianghong Yang ◽  
...  
Keyword(s):  
Interaction Effect ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Social Function ◽  
Time Effect ◽  
Control Group ◽  
Positive Symptoms ◽  
Symptom Scale ◽  
Grouping Effect ◽  
The Difference

BackgroundThe impairment of social function is widespread in the patients with chronic schizophrenia, which seriously affects family, life and work conditions.AimsThe main purpose of this study was to investigate the efficacy of paliperidone in the treatment of social function in chronic schizophrenia.MethodsA total of 81 patients who met the standard criteria for schizophrenia and long-term hospitalised inpatients were randomly divided into the treatment group and normal control group following a 1- year prospective follow-up study. The reatment group (41 cases) used paliperidone extended-release tablets for reducing dosage, as appropriate, based on the original treatment strategy; and the control group (40 cases) used the former drugs. All patients were assessed using the Positive and Negative Symptom Scales (PANSS), and the Treatment Emergent Symptom Scale (TESS) was used to assess adverse drug reactions. The Hospitalised Psychiatric Patients’ Social Functions Rating Scale (SSPI) was used to assess social function of participants before and after 8  weeks, 6  months and 1 year of treatment.ResultsAt baseline there were no significant differences between the two groups in age, duration of illness, educational background and dosage of antipsychotic drugs (converted into chlorpromazine equivalency). There was statistically significant difference in PANSS positive symptoms by interaction effect (Fgroup×time=18.24, df=3237, p<0.001) and time effect (Ftime=21.66, df=3, p<0.01) and the difference in PANSS positive symptoms by grouping effect (Fgroup=0.68, df=1, p=0.41) was not statistically significant. The difference of grouping effect of PANSS negative symptoms (Fgroup=9.93, df=1, p=0.002), time effect (Ftime=279.15, df=3, p<0.001) and interaction effect (Fgroup×time=279.15, df=3237, p<0.001) were statistically significant. There were statistically significant differences in the grouping effect (Fgroup=6.59, df=1, p=0.012), time effect (Ftime=152.97, df=3, p<0.001) and interaction effect (Fgroup×time=148.82, df=3237, p<0.001) of PANSS general pathological symptoms, the same as the total score of the PANSS, which showed large differences in grouping effect (Fgroup=7.04, df=1, p=0.001), time effect (Ftime=210.78, df=3, p<0.001) and interaction effect (Fgroup×time=205.20, df=3237, p<0.01). We found in the total SSPI score, grouping effect (Fgroup=31.70, df=1, p<0.001), time effect (Ftime=161.84, df=3, p<0.001) and interaction effect (Fgroup×time=132.74, df=3237, p<0.001) were demonstrated to be significantly different. Even though adverse reactions occurred 7 times in the treatment group and 44 times in the control group based on the Treatment Emergent Symptom Scale (TESS), incidence rate was significantly lower than that of the control group (χ²=18.854, p<0.001).ConclusionPaliperidone can safely and effectively improve negative symptoms and social function in patients with chronic schizophrenia.

scholarly journals Neural correlates of positive and negative symptoms through the illness course: an fMRI study in early psychosis and chronic schizophrenia

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Lucy D. Vanes ◽  
Elias Mouchlianitis ◽  
Krisna Patel ◽  
Erica Barry ◽  
Katie Wong ◽  
...  
Keyword(s):  
Cognitive Control ◽  
Symptom Severity ◽  
Negative Symptoms ◽  
Neural Circuits ◽  
Chronic Schizophrenia ◽  
Early Psychosis ◽  
Positive Symptoms ◽  
Precentral Gyrus ◽  
Initial Development ◽  
Positive And Negative Symptoms

Abstract Psychotic illness is associated with cognitive control deficits and abnormal recruitment of neural circuits subserving cognitive control. It is unclear to what extent this dysfunction underlies the development and/or maintenance of positive and negative symptoms typically observed in schizophrenia. In this study we compared fMRI activation on a standard Stroop task and its relationship with positive and negative symptoms in early psychosis (EP, N = 88) and chronic schizophrenia (CHR-SZ, N = 38) patients. CHR-SZ patients showed reduced frontal, striatal, and parietal activation across incongruent and congruent trials compared to EP patients. Higher positive symptom severity was associated with reduced activation across both trial types in supplementary motor area (SMA), middle temporal gyrus and cerebellum in EP, but not CHR-SZ patients. Higher negative symptom severity was associated with reduced cerebellar activation in EP, but not in CHR-SZ patients. A negative correlation between negative symptoms and activation in SMA and precentral gyrus was observed in EP patients and in CHR-SZ patients. The results suggest that the neural substrate of positive symptoms changes with illness chronicity, and that cognitive control related neural circuits may be most relevant in the initial development phase of positive symptoms. These findings also highlight a changing role for the cerebellum in the development and later maintenance of both positive and negative symptoms.

Two kinds of cognitive deficit associated with chronic schizophrenia

1977 ◽  
Vol 7 (1) ◽  
pp. 171-173 ◽  
Author(s):  
C. D. Frith
Keyword(s):  
Feature Selection ◽  
Negative Symptoms ◽  
Cognitive Deficit ◽  
Chronic Schizophrenia ◽  
Positive Symptoms ◽  
Chronic Schizophrenic ◽  
Normal Degree ◽  
Schizophrenic Patients

SynopsisThe performance of 21 chronic schizophrenic patients was investigated on two tests of feature selection. It was found that patients with negative symptoms (muteness, withdrawal, etc.) were characterized by an extreme lack of persistence, but selected usual features; whereas patients with positive symptoms (hallucinations, delusions, etc.) had a normal degree of persistence, but selected unusual features.

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