Pathophysiology and treatment of negative symptoms

Abstract

The assessment and clinical characterization of the negative symptoms of schizophrenia are reviewed. While negative symptoms may be secondary to positive symptoms, extrapyramidal side-effects, depressive illness, chronic institutionalization or other factors, they may also be primary, i.e., integral to the disease process itself. Recent literature has suggested that negative symptoms may represent a distinct pathophysiological process mediated in part by serotonergic mechanisms. Atypical neuroleptics, which have dual effects on D2/5-HT2 receptors, have demonstrated clinical efficacy on both negative and positive symptoms of schizophrenia, and might help to clarify the pathogenesis of these symptom clusters.