[Pharmacological treatment of negative symptoms in schizophrenia; research and practice]

Abstract

Background: Negative symptoms in patients with schizophrenia predict a worse social outcome. The treatment options for negative symptoms are extremely limited. Various treatment strategies have been studied in which several types of medication were added to antipsychotics in order to alleviate negative symptoms.

Aim: To review the types of medication that have been used to supplement antipsychotic treatment in order to alleviate negative symptoms in patients with schizophrenia.

Method: By means of PubMed we were able to perform a systematic review of all randomised controlled trials and relevant meta-analyses published up to and including May 2009.

Results: The pharmacological mechanisms that were studied in connection with the treatment of negative symptoms were as follows: the modulation of the glutamate system, the modulation of the serotonergic system, the histaminergic system and the dopaminergic system and the influencing by means of antioxidants and hormones. Despite all the methodological problems the modulation of the glutamate system and the blocking of serotonin 5-HT-3/2a receptors may be able to bring about a limited reduction of negative symptoms. The therapeutic results of the pharmacological treatments studied which may be effective is only moderate.

Conclusion: For the time being the pharmacological addition strategies do not lead us to recommend their use in current clinical practice but they can certainly serve as a basis for further research. medication, negative symptoms, schizophrenia.