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Adjunctive Antidepressant Drug Therapies in the Treatment of Negative Symptoms of Schizophrenia

 

作者: A. Eden Evins,   Donald C. Goff,  

 

期刊: CNS Drugs  (ADIS Available online 1996)
卷期: Volume 6, issue 2  

页码: 130-147

 

ISSN:1172-7047

 

年代: 1996

 

出版商: ADIS

 

数据来源: ADIS

 

摘要:

The negative symptoms of schizophrenia comprise one of several identified symptom clusters associated with the disorder. Although consensus on the precise components of the negative syndrome and on definitions for specific negative symptoms have not been reached, for the purpose of this review, negative symptoms include blunted affect, poverty of thought content and speech, apathy, social withdrawal and anergia. Negative symptoms are among the most disabling and treatment-resistant symptoms of schizophrenia, and various approaches to treatment have been taken, including augmentation of conventional antipsychotic treatment with antidepressants.Assessment of the effect of treatments on negative symptoms can be problematic and, therefore, clinical trials need to be of adequate duration and systematic attempts need to be made to rule out secondary causes of negative symptoms that may mimic or exacerbate them.Placebo-controlled studies of fluoxetine and fluvoxamine, which controlled for secondary negative symptoms, have demonstrated substantial improvement in negative symptoms compared with placebo. Significant exacerbation in psychotic symptoms was not reported in these controlled trials. This, therefore, represents a promising clinical option for treating negative symptoms.It appears that the maximum benefit of antidepressant augmentation may not be achieved until at least 12 weeks after initiation of therapy. Therefore, trials of shorter duration may understate the potential efficacy of this combination.

 

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