L-DOPA in the Treatment of Negative Schizophrenic Symptoms: A Single-Subject Experimental Study

1986 ◽  
Vol 15 (3) ◽  
pp. 293-298 ◽  
Author(s):  
Stanley R. Kay ◽  
Lewis A. Opler
Keyword(s):  
Negative Symptoms ◽  
Psychomotor Retardation ◽  
Adjunctive Treatment ◽  
Single Subject ◽  
Abstract Thinking ◽  
Positive Symptoms ◽  
Drug Induced ◽  
Double Blind ◽  
Reversal Design ◽  
Negative Syndrome

Adjunctive Sinemet (L-DOPA plus carbidopa) therapy was assessed for a neuroleptic nonresponsive schizophrenic with a longstanding negative syndrome. A twenty-seven week double-blind placebo-controlled reversal design found significant improvement specifically for negative symptoms while treated with combined haloperidol-Sinemet as compared against haloperidol-placebo. The eight-week adjunctive treatment reversed a worsening trend in attention, abstract thinking, passive withdrawal, psychomotor retardation, and a cluster of seven negative parameters, while positive symptoms were unaffected. This seemed to represent more than simple reversal of drug-induced akinesia and underscores the importance of distinguishing between positive and negative syndromes in psychopharmacological research.

scholarly journals Galantamine as Adjunctive Treatment for Ameliorating Negative Symptoms of Schizophrenia Patients

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Zahra Roshandel ◽  
Shahin Norouzi ◽  
Mohammad Reze Haghdoost ◽  
Ahmad Fakhri
Keyword(s):  
Negative Symptoms ◽  
Antipsychotic Drugs ◽  
Intervention Group ◽  
Adjunctive Treatment ◽  
Control Group ◽  
Double Blind ◽  
Syndrome Scale ◽  
Psychiatric Department ◽  
Negative Syndrome ◽  
Positive And Negative Symptoms

Background: Schizophrenia is one of the most serious mental disorders presenting in adolescence. Antipsychotic drugs are the basis of treatment and clinical management of patients with schizophrenia. Despite the efficacy of risperidone as one of the antipsychotic drugs, about two-thirds of patients may experience both positive and negative symptoms during their life. Objectives: We evaluated the efficacy of galantamine as an adjunctive treatment for ameliorating the negative symptoms of schizophrenia patients. Methods: This is a randomized double-blind phase II clinical trial study carried out on schizophrenia patients admitted to a psychiatric department. The patients were randomly divided into two equal groups using the block randomization method. The intervention group received 24 mg galantamine plus 2 - 6 mg risperidone, and controls received 24 mg placebo along with 2 - 6 mg risperidone. Neurological tests included the Scale for the Assessment of Negative Symptoms (SANS) and the Positive and Negative Syndrome Scale (PANSS) at baseline and weeks 2, 4, and 8 after treatment. Results: We studied 28 patients. The mean age of the participants was 44 ± 3.1 and 47 ± 2.7 years in the placebo and intervention groups, respectively. The PANSS score significantly decreased over study time. The intervention group showed significantly greater reduction slopes than the control group (P = 0.034). Alogia (P = 0.0016) and attention (P = 0.0108) reduced more intensely in the intervention group than in the control group. Conclusions: Our findings indicated that galantamine could significantly affect the severity of the symptoms of schizophrenia patients. The findings suggest galantine as an appropriate adjunctive treatment for ameliorating negative symptoms, especially attention and alogia.

scholarly journals Memantine augmentation in clozapine-refractory schizophrenia: a randomized, double-blind, placebo-controlled crossover study

2016 ◽  
Vol 46 (9) ◽  
pp. 1909-1921 ◽  
Author(s):  
S. R. T. Veerman ◽  
P. F. J. Schulte ◽  
J. D. Smith ◽  
L. de Haan
Keyword(s):  
Executive Function ◽  
Nmda Receptor ◽  
Side Effects ◽  
Effect Size ◽  
Visual Memory ◽  
Negative Symptoms ◽  
Rating Scale ◽  
Adjunctive Treatment ◽  
Positive Symptoms ◽  
Double Blind

BackgroundDysfunction of neuroplasticity due to N-methyl-d-aspartate (NMDA) receptor hypofunction may be a causal factor for memory and executive dysfunctioning in schizophrenia. Deregulation of NMDA transmission in the prefrontal cortex may also explain negative and positive symptoms. Clozapine augmentation with memantine targets altered NMDA receptor-mediated neurotransmission in schizophrenia and showed substantial beneficial effects on several symptom domains in a small proof-of-concept study. We evaluate effects of memantine add-on treatment to clozapine for memory and executive function, and negative and positive symptoms in schizophrenia.MethodClozapine-treated patients with refractory schizophrenia were randomly assigned to 12 weeks of double-blind adjunctive treatment with memantine (n = 26) or placebo (n = 26). Crossover occurred after a 2-week placebo wash-out period. Primary endpoints were change from baseline to 12 weeks treatment and 14 weeks to 26 weeks treatment on memory and executive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB), Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impression Severity Scale (CGI-S). Side effects were assessed using the Liverpool University Neuroleptic Side-Effect Rating Scale.ResultsWhen compared with placebo, memantine improved a composite memory score comprising verbal recognition memory and paired associates learning task scores on the CANTAB (effect size = 0.30) and PANSS negative subscale score (effect size = 0.29). Side effects were mild and transient.ConclusionsIn patients with clozapine-treated refractory schizophrenia, memantine addition significantly improved verbal and visual memory and negative symptoms without serious adverse effects. These results justify further investigations on long-term memantine augmentation to clozapine in treatment-resistant schizophrenia.

scholarly journals Adjunctive Garcinia mangostana Linn. (Mangosteen) Pericarp for Schizophrenia: A 24-Week Double-blind, Randomized, Placebo Controlled Efficacy Trial: Péricarpe d’appoint Garcinia mangostana Linn (mangoustan) pour la schizophrénie : un essai d’efficacité de 24 semaines, à double insu, randomisé et contrôlé par placebo

2020 ◽  
pp. 070674372098243
Author(s):  
Alyna Turner ◽  
Andrea Baker ◽  
Olivia M. Dean ◽  
Adam J. Walker ◽  
Seetal Dodd ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Schizoaffective Disorder ◽  
Negative Symptoms ◽  
Controlled Trial ◽  
Safety Data ◽  
Rate Of Change ◽  
Adjunctive Treatment ◽  
Garcinia Mangostana ◽  
Double Blind

Objectives: Garcinia mangostana Linn. (“mangosteen”) pericarp contains bioactive compounds that may target biological pathways implicated in schizophrenia. We conducted a double-blind randomized placebo-controlled trial evaluating the efficacy of adjunctive mangosteen pericarp, compared to placebo, in the treatment of schizophrenia. Methods: People diagnosed with schizophrenia or schizoaffective disorder ( Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), recruited across 2 sites (Brisbane and Victoria, Australia), were randomized to receive 24 weeks of adjunctive mangosteen pericarp (1,000 mg/day) or matched placebo. The primary outcome measure was the Positive and Negative Symptom Scale total score. Secondary outcomes included positive and negative symptoms, general psychopathology, clinical global severity and improvement, participant reported overall improvement, depressive symptoms, functioning, quality of life, and safety data at 24 and 28 weeks (4 weeks postdiscontinuation). Data were collected from July 2016 to February 2019. Results: Baseline assessments were conducted on 148 people (mangosteen = 74, placebo = 74); data analyses were conducted on 136 (92%) participants with postbaseline data. The treatment group had significantly higher symptom severity compared to placebo, and both groups significantly improved on all symptom, functioning, and quality of life measures over time. No between-group differences were found for the rate of change between baseline and 24 or 28 weeks. Conclusion: Despite promising preclinical and clinical work, our results do not support mangosteen pericarp extract as an adjunctive treatment for schizophrenia or schizoaffective disorder.

Efficacy of lurasidone across five symptom dimensions of schizophrenia: Pooled analysis of short-term, placebo-controlled studies

2015 ◽  
Vol 30 (1) ◽  
pp. 26-31 ◽  
Author(s):  
A. Loebel ◽  
J. Cucchiaro ◽  
R. Silva ◽  
Y. Mao ◽  
J. Xu ◽  
...  
Keyword(s):  
Effect Size ◽  
Repeated Measures ◽  
Negative Symptoms ◽  
Mixed Model ◽  
Five Factor Model ◽  
Pooled Analysis ◽  
Positive Symptoms ◽  
Factor Scores ◽  
Short Term ◽  
Double Blind

AbstractObjective:To evaluate the efficacy of lurasidone for schizophrenia using an established five-factor model of the Positive and Negative Syndrome Scale (PANSS).Methods:Patient-level data were pooled from five randomized, double-blind, placebo-controlled, 6-week studies of lurasidone (fixed doses, 40–160 mg/d) for patients with an acute exacerbation of schizophrenia. Changes in five established PANSS factors were assessed using mixed-model repeated measures analysis.Results:Compared with placebo (n = 496), lurasidone (n = 1029, dose groups pooled) significantly improved the PANSS total score at Week 6 (−22.6 vs. −12.8; P < 0.001; effect size, 0.45), as well as all factor scores (P < 0.001 for each): positive symptoms (−8.4 vs. −6.0; effect size, 0.43), negative symptoms (−5.2 vs. −3.3; effect size, 0.33), disorganized thought (−4.9 vs. −2.8; effect size, 0.42), hostility/excitement (−2.7 vs. −1.6; effect size, 0.31), and depression/anxiety (−3.2 vs. −2.3; effect size, 0.31). Separation from placebo occurred at Week 1 for the positive symptoms, disorganized thought, and hostility/excitement factors and at Week 2 for the other factors.Conclusions:In this pooled analysis of short-term studies in patients with acute schizophrenia, lurasidone demonstrated significant improvement for each of the five PANSS factor scores, indicating effectiveness across the spectrum of schizophrenia symptoms.

Evidence of Brain Dopamine Deficiency in Schizophrenia

1979 ◽  
Vol 24 (7) ◽  
pp. 661-667 ◽  
Author(s):  
Guy Chouinard ◽  
Barry D. Jones
Keyword(s):  
Negative Symptoms ◽  
Late Onset ◽  
Pharmacological Therapy ◽  
Positive Symptoms ◽  
Short Term ◽  
Onset Of Action ◽  
Double Blind ◽  
Dopamine Hypothesis ◽  
Term Basis ◽  
Dopamine Supersensitivity

Summary It is proposed that the increased dopamine function suggested by the dopamine hypothesis of schizophrenia is a dopaminergic postsynaptic receptor supersensitivity resulting from a dopamine deficiency. In support of this, three double-blind controlled studies conducted on drugs which alter brain dopaminergic activity in a manner different from that of classic neuroleptics are reported. 1) α-methyldopa-neuroleptic interaction proved efficacious for schizophrenic positive symptoms but only on a short-term basis. 2) Rubidium improved negative symptoms rapidly, and in contrast has a late onset of action on positive symptoms of schizophrenia. 3) Tryptophan-benserazide was efficacious in controlling both negative and positive symptoms of schizophrenia (although less so than chlorpromazine). It is concluded that currently accepted modes of pharmacological therapy (classical neuroleptics) are in the short-term controlling the dopamine supersensitivity secondary to a deficiency, but contributing in the long-term to increase the dopamine deficiency, and so exacerbate the supersensitivity. More effective forms of treatment may involve the use of agents which alter dopamine activity without inducing dopamine supersensitivity.

The Concept of Negative Symptoms

1989 ◽  
Vol 155 (S7) ◽  
pp. 10-14 ◽  
Author(s):  
J.K. Wing
Keyword(s):  
Negative Symptoms ◽  
Research Council ◽  
Medical Research Council ◽  
Research Unit ◽  
Positive Symptoms ◽  
The Social ◽  
History Of ◽  
Recent Edition ◽  
Negative Syndrome ◽  
The Relationship

In a recent edition of the Schizophrenia Bulletin devoted to negative symptoms, the editor suggested at the beginning of his preface that what he called the “positive–negative symptom distinction” had been introduced into psychiatry only a decade previously (Levine, 1985). Many authors in the same volume seemed to agree with him; at least they did not emphasise any continuity with earlier work. There were a few notable exceptions. Since, for more than 30 years, I have seen the relationship between psychological deficit (cognitive defect, negative syndrome) and the productive (florid, positive) symptoms as lying at the heart of the mystery of schizophrenia, it seemed possible that some account of how that interest arose and developed might still be timely. This is part of the history of the Social Psychiatry Research Unit of the Medical Research Council.

scholarly journals Symptom Outcome 1 Year after Admission to an Early Psychosis Program

2003 ◽  
Vol 48 (3) ◽  
pp. 204-207 ◽  
Author(s):  
Jean Addington ◽  
Erin Leriger ◽  
Donald Addington
Keyword(s):  
Negative Symptoms ◽  
Depression Scale ◽  
Early Psychosis ◽  
First Episode ◽  
First Year ◽  
Positive Symptoms ◽  
Syndrome Scale ◽  
Assessment Measures ◽  
Symptom Outcome ◽  
Negative Syndrome

Objective: To determine the change in positive, negative, and depressive symptoms after 1 year in an early psychosis program. Method: One hundred and eighty subjects were included from the first 257 admissions for a first episode of psychosis to a comprehensive early psychosis program. Most had a diagnosis of schizophrenia or schizophreniform disorder. Subjects were assessed on admission to the program and at 3, 6, and 12 months after admission. All 180 subjects completed the 1-year assessment. Assessment measures included the Positive and Negative Syndrome Scale and the Calgary Depression Scale for Schizophrenia. Results: There was a clinically and statistically significant improvement in positive symptoms by 3 months, depression increased at 3 months but significantly improved by 12 months, and negative symptoms changed little over the first year. Conclusions: The differential changes in symptoms in the first year after admission have implications for treatment.

scholarly journals A Comparative Study between Olanzapine and Risperidone in the Management of Schizophrenia

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Saeed Shoja Shafti ◽  
Mahsa Gilanipoor
Keyword(s):  
Negative Symptoms ◽  
Primary Outcome ◽  
Positive Symptoms ◽  
Random Allocation ◽  
Severity Scale ◽  
Double Blind ◽  
Safety And Efficacy ◽  
Superior Efficacy ◽  
Schizophrenic Patients ◽  
Risperidone Group

Introduction. Since a variety of comparisons between risperidone and olanzapine have resulted in diverse outcomes, so safety and efficacy of them were compared again in a new trial.Method. Sixty female schizophrenic patients entered into one of the assigned groups for random allocation to olanzapine or risperidone (n=30in each group) in a double-blind, 12-week clinical trial. Scale for Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS) were used as the primary outcome measures. Clinical Global Impressions-Severity Scale (CGI-S), Schedule for Assessment of Insight (SAI), and finally Simpson Angus Scale (SAS) as well were employed as secondary scales.Results. While both of olanzapine and risperidone were significantly effective for improvement of positive symptoms (P<0.0001), as regards negative symptoms, it was so only by means of olanzapine (P<0.0003). CGI-S and SAI, as well, were significantly improved in both of the groups. SAS increment was significant only in the risperidone group (P<0.02).Conclusion. While both of olanzapine and risperidone were equally effective for improvement of positive symptoms and insight, olanzapine showed superior efficacy with respect to negative symptoms, along with lesser extrapyramidal side effects, in comparison with risperidone.

scholarly journals Shifts in positive and negative psychotic symptoms and anger: effects on violence

2018 ◽  
Vol 48 (14) ◽  
pp. 2428-2438 ◽  
Author(s):  
Jeremy W. Coid ◽  
Constantinos Kallis ◽  
Mike Doyle ◽  
Jenny Shaw ◽  
Simone Ullrich
Keyword(s):  
Community Violence ◽  
Negative Symptoms ◽  
Positive Symptom ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Protective Effects ◽  
Post Discharge ◽  
Affective Symptoms ◽  
Syndrome Scale ◽  
Negative Syndrome

BackgroundChanges in positive and negative symptom profiles during acute psychotic episodes may be key drivers in the pathway to violence. Acute episodes are often preceded by fluctuations in affect before psychotic symptoms appear and affective symptoms may play a more important role in the pathway than previously recognised.MethodsWe carried out a prospective cohort study of 409 male and female patients discharged from medium secure services in England and Wales to the community. Measures were taken at baseline (pre-discharge), 6 and 12 months post-discharge using the Positive and Negative Syndrome Scale. Information on violence was obtained using the McArthur Community Violence Instrument and Police National Computer.ResultsThe larger the shift in positive symptoms the more likely violence occurred in each 6-month period. However, shifts in angry affect were the main driving factor for positive symptom shifts associated with violence. Shifts in negative symptoms co-occurred with positive and conveyed protective effects, but these were overcome by co-occurring shifts in anger. Severe but stable delusions were independently associated with violence.ConclusionsIntensification of angry affect during acute episodes of psychosis indicates the need for interventions to prevent violence and is a key driver of associated positive symptoms in the pathway to violence. Protective effects against violence exerted by negative symptoms are not clinically observable during symptom shifts because they are overcome by co-occurring anger.

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