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Novel antipsychotics and negative symptoms.

Abstract

Negative symptoms are a key feature of schizophrenia. Novel (atypical) antipsychotic drugs, unlike conventional antipsychotics, cause substantial reductions in Positive and Negative Symptom Scale (PANSS) scores. Negative symptoms, however, can arise from both the pathology of the disease (primary negative symptoms) and as side effects of antipsychotic drugs (secondary negative symptoms). Before the efficacy of a drug against negative symptoms can be determined, the physician must establish whether the positive results stem from reductions in primary negative symptoms or are merely due to improved extrapyramidal tolerability. Until recently, shortcomings in the design of clinical trials and the lack of distinction between primary and secondary symptoms made it impossible to answer this question. However, advances in clinical trial methodologies now make it possible to assess negative symptoms accurately, and a complex statistical approach, the path analysis, has been developed to differentiate between the direct and indirect effects of antipsychotic drugs on negative symptoms. With this approach, it has been shown that the efficacy of novel antipsychotics, such as sertindole, against negative symptoms is achieved largely through direct effects on primary negative symptoms. The requirements for an accurate assessment and differentiation of negative symptoms are outlined, and the importance of this for improving the treatment of schizophrenia is emphasized.

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  • Authors+Show Affiliations

    Psychiatrische Klinik und Poliklinik, Ludwig Maximilians Universität München, Munich, Germany.

    Source

    International clinical psychopharmacology 13 Suppl 3: 1998 Mar pg S43-7

    MeSH

    Antipsychotic Agents
    Clinical Trials as Topic
    Depression
    Humans
    Imidazoles
    Indoles
    Psychiatric Status Rating Scales
    Schizophrenia
    Schizophrenic Psychology
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    9690970

    Citation

    Möller, H J.. "Novel Antipsychotics and Negative Symptoms." International Clinical Psychopharmacology, vol. 13 Suppl 3, 1998, pp. S43-7.
    Möller HJ. Novel antipsychotics and negative symptoms. Int Clin Psychopharmacol. 1998;13 Suppl 3:S43-7.
    Möller, H. J. (1998). Novel antipsychotics and negative symptoms. International Clinical Psychopharmacology, 13 Suppl 3, pp. S43-7.
    Möller HJ. Novel Antipsychotics and Negative Symptoms. Int Clin Psychopharmacol. 1998;13 Suppl 3:S43-7. PubMed PMID: 9690970.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Novel antipsychotics and negative symptoms. A1 - Möller,H J, PY - 1998/8/5/pubmed PY - 1998/8/5/medline PY - 1998/8/5/entrez SP - S43 EP - 7 JF - International clinical psychopharmacology JO - Int Clin Psychopharmacol VL - 13 Suppl 3 N2 - Negative symptoms are a key feature of schizophrenia. Novel (atypical) antipsychotic drugs, unlike conventional antipsychotics, cause substantial reductions in Positive and Negative Symptom Scale (PANSS) scores. Negative symptoms, however, can arise from both the pathology of the disease (primary negative symptoms) and as side effects of antipsychotic drugs (secondary negative symptoms). Before the efficacy of a drug against negative symptoms can be determined, the physician must establish whether the positive results stem from reductions in primary negative symptoms or are merely due to improved extrapyramidal tolerability. Until recently, shortcomings in the design of clinical trials and the lack of distinction between primary and secondary symptoms made it impossible to answer this question. However, advances in clinical trial methodologies now make it possible to assess negative symptoms accurately, and a complex statistical approach, the path analysis, has been developed to differentiate between the direct and indirect effects of antipsychotic drugs on negative symptoms. With this approach, it has been shown that the efficacy of novel antipsychotics, such as sertindole, against negative symptoms is achieved largely through direct effects on primary negative symptoms. The requirements for an accurate assessment and differentiation of negative symptoms are outlined, and the importance of this for improving the treatment of schizophrenia is emphasized. SN - 0268-1315 UR - https://www.unboundmedicine.com/medline/citation/9690970/Novel_antipsychotics_and_negative_symptoms_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=9690970.ui DB - PRIME DP - Unbound Medicine ER -