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The effect of neuroleptics and other psychotropic drugs on negative symptoms in schizophrenia.

Abstract

It has been hypothesized that the negative symptoms of schizophrenia are related to structural brain abnormalities and respond poorly to treatment with neuroleptics and other drugs since they are persistent, if not irreversible. Because this issue has important clinical and theoretical implications, the authors reviewed the relevant literature on the effect of neuroleptics, L-dopa, and other psychotropic agents on these symptoms. Contrary to the above conclusions, several large scale, controlled studies of the therapeutic effects of conventional neuroleptics have reported clinically relevant improvement in negative symptoms in a significant proportion of schizophrenics. The improvement tended to occur early in the course of treatment and was most notable in those patients with relatively shorter durations of illness. A specific class of neuroleptic drugs not studied in these earlier large scale trials, the diphenylbutylpiperidines, has been suggested to be particularly likely to ameliorate negative symptoms, possibly because of their significant calcium channel blocking action. A review of the clinical studies comparing this group of neuroleptics with those from different classes supports the suggestion that they can produce greater improvement in anergia and emotional withdrawal. Six open and four controlled trials of L-dopa treatment of negative symptoms with L-dopa alone or in combination with neuroleptics. As with neuroleptics alone, improvement tended to be greater in those with a shorter duration of illness. The available evidence suggests that negative symptoms, at least in less chronic schizophrenic patients, may be partially responsive to currently available pharmacological intervention in a significant proportion of schizophrenics.

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    MeSH

    Alprazolam
    Antipsychotic Agents
    Chronic Disease
    Clinical Trials as Topic
    Dextroamphetamine
    Dose-Response Relationship, Drug
    Double-Blind Method
    Drug Therapy, Combination
    Humans
    Levodopa
    Propranolol
    Psychiatric Status Rating Scales
    Psychotropic Drugs
    Schizophrenia
    Schizophrenic Psychology

    Pub Type(s)

    Clinical Trial
    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    2879856

    Citation

    Meltzer, H Y., et al. "The Effect of Neuroleptics and Other Psychotropic Drugs On Negative Symptoms in Schizophrenia." Journal of Clinical Psychopharmacology, vol. 6, no. 6, 1986, pp. 329-38.
    Meltzer HY, Sommers AA, Luchins DJ. The effect of neuroleptics and other psychotropic drugs on negative symptoms in schizophrenia. J Clin Psychopharmacol. 1986;6(6):329-38.
    Meltzer, H. Y., Sommers, A. A., & Luchins, D. J. (1986). The effect of neuroleptics and other psychotropic drugs on negative symptoms in schizophrenia. Journal of Clinical Psychopharmacology, 6(6), pp. 329-38.
    Meltzer HY, Sommers AA, Luchins DJ. The Effect of Neuroleptics and Other Psychotropic Drugs On Negative Symptoms in Schizophrenia. J Clin Psychopharmacol. 1986;6(6):329-38. PubMed PMID: 2879856.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The effect of neuroleptics and other psychotropic drugs on negative symptoms in schizophrenia. AU - Meltzer,H Y, AU - Sommers,A A, AU - Luchins,D J, PY - 1986/12/1/pubmed PY - 1986/12/1/medline PY - 1986/12/1/entrez SP - 329 EP - 38 JF - Journal of clinical psychopharmacology JO - J Clin Psychopharmacol VL - 6 IS - 6 N2 - It has been hypothesized that the negative symptoms of schizophrenia are related to structural brain abnormalities and respond poorly to treatment with neuroleptics and other drugs since they are persistent, if not irreversible. Because this issue has important clinical and theoretical implications, the authors reviewed the relevant literature on the effect of neuroleptics, L-dopa, and other psychotropic agents on these symptoms. Contrary to the above conclusions, several large scale, controlled studies of the therapeutic effects of conventional neuroleptics have reported clinically relevant improvement in negative symptoms in a significant proportion of schizophrenics. The improvement tended to occur early in the course of treatment and was most notable in those patients with relatively shorter durations of illness. A specific class of neuroleptic drugs not studied in these earlier large scale trials, the diphenylbutylpiperidines, has been suggested to be particularly likely to ameliorate negative symptoms, possibly because of their significant calcium channel blocking action. A review of the clinical studies comparing this group of neuroleptics with those from different classes supports the suggestion that they can produce greater improvement in anergia and emotional withdrawal. Six open and four controlled trials of L-dopa treatment of negative symptoms with L-dopa alone or in combination with neuroleptics. As with neuroleptics alone, improvement tended to be greater in those with a shorter duration of illness. The available evidence suggests that negative symptoms, at least in less chronic schizophrenic patients, may be partially responsive to currently available pharmacological intervention in a significant proportion of schizophrenics. SN - 0271-0749 UR - https://www.unboundmedicine.com/medline/citation/2879856/The_effect_of_neuroleptics_and_other_psychotropic_drugs_on_negative_symptoms_in_schizophrenia_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=2879856.ui DB - PRIME DP - Unbound Medicine ER -