Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 3;12(5):282-299.
doi: 10.9740/mhc.2022.10.282. eCollection 2022 Oct.

Management of cognitive and negative symptoms in schizophrenia

Affiliations

Management of cognitive and negative symptoms in schizophrenia

Megan Maroney. Ment Health Clin. .

Abstract

Currently available antipsychotics provide only modest benefit in managing the cognitive and negative symptoms of schizophrenia even though these symptoms are often the most impairing in patients' daily lives. Certain antipsychotics may have slight benefits over others, and several nonpharmacologic and pharmacologic adjunctive treatments have been evaluated in recent clinical trials. Recently published meta-analyses and clinical studies of such treatments are reviewed. Potential strategies to manage cognitive and negative symptoms, including deprescribing of medications that may exacerbate these symptoms, are described using theoretical case examples.

Keywords: anticholinergic; antipsychotics; cognitive symptoms; negative symptoms; schizophrenia.

PubMed Disclaimer

Conflict of interest statement

Disclosures: I have served on an advisory board for Boehringer Ingelheim, Pharmacy Times Health-Systems Edition, Sunovion Pharmaceuticals; am a consultant for Novus Medical Education; received honoraria from the American College of Clinical Pharmacy, Elsevier Publishing, New Jersey Society of Health Systems-Pharmacists, Pharmacy Times Continuing Education; and was a part of the Otsuka Pharmaceuticals Speaker's Bureau. Psychopharmacology Pearls are review articles intended to highlight both the evidence base available and/or controversial areas of clinical care for psychiatric and neurologic conditions as well as strategies of clinical decision making used by expert clinicians. As pearls, articles reflect the views and practice of each author as substantiated with evidence-based facts as well as opinion and experience. Articles are edited by members of the Psychopharmacology Pearls Editorial Board as well as peer-reviewed by MHC reviewers. This article was developed as part of the 2022 Psychopharmacology Pearls product for BCPP recertification credit. The course information and testing center is at https://aapp.org/503974.

Similar articles

Cited by

References

    1. Carbon M, Correll CU. Thinking and acting beyond the positive: the role of the cognitive and negative symptoms in schizophrenia. CNS Spectr. 2014;19(Suppl 1):38–52. quiz 35-7, 53. https://doi.org/10.1017/S1092852914000601 PubMed PMID: 25403863. - DOI - PubMed
    1. Galderisi S, Mucci A, Dollfus S, Nordentoft M, Falkai P, Kaiser S, et al. EPA guidance on assessment of negative symptoms in schizophrenia. Eur Psychiatr. 2021;64(1):e23. https://doi.org/10.1192/j.eurpsy.2021.11 PubMed PMID: 33597064 PubMed Central PMCID: PMC8080207. - DOI - PMC - PubMed
    1. Fleischhacker WW, Podhorna J, Gröschl M, Hake S, Zhao Y, Huang S, et al. Efficacy and safety of the novel glycine transporter inhibitor BI 425809 once daily in patients with schizophrenia: a double-blind, randomised, placebo-controlled phase 2 study. Lancet Psychiatry. 2021;8(3):191–201. doi: 10.1016/S2215-0366(20)30513-7. - DOI - PubMed
    1. Davidson M, Saoud J, Staner C, Noel N, Werner S, Luthringer E, et al. Efficacy and safety of roluperidone for the treatment of negative symptoms of schizophrenia. Schizophr Bull. 2022;48(3):609–19. https://doi.org/10.1093/schbul/sbac013 PubMed PMID: 35211743 PubMed Central PMCID: PMC9077422. - DOI - PMC - PubMed
    1. Bugarski-Kirola D, Arango C, Fava M, Nasrallah H, Liu I-Y, Abbs B, et al. Pimavanserin for negative symptoms of schizophrenia: results from the ADVANCE phase 2 randomised, placebo-controlled trial in North America and Europe. Lancet Psychiatry. 2022;9:46–58. doi: 10.1016/S2215-0366(21)00386-2. - DOI - PubMed

LinkOut - more resources