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Treatment of negative and cognitive symptoms

D C Javitt1

  • 1Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA.

Current Psychiatry Reports
|December 21, 2000
PubMed

Insights

Schizophrenia treatment is improving with atypical antipsychotics and N-methyl-d-aspartate (NMDA) receptor agonists. These therapies offer new hope for reducing negative symptoms and cognitive dysfunction in schizophrenia patients.

Area of Science:

  • Neuroscience and Psychiatry
  • Pharmacological interventions for mental health disorders

Background:

  • Schizophrenia is characterized by persistent negative symptoms and cognitive deficits, leading to chronic disability.
  • Atypical antipsychotics show greater efficacy in improving negative symptoms compared to conventional agents, but their precise mechanism is debated.
  • Secondary psychopathology may confound the assessment of core negative symptoms with current treatments.

Purpose of the Study:

  • To evaluate the efficacy of N-methyl-d-aspartate (NMDA) receptor-stimulating agents as an adjunct therapy for schizophrenia.
  • To investigate the potential of NMDA receptor agonists to improve negative and cognitive symptoms in schizophrenia.
  • To differentiate the effects of atypical antipsychotics on core negative symptoms versus secondary psychopathology.

Main Methods:

  • Review of studies investigating atypical antipsychotics (e.g., clozapine, risperidone, olanzapine) for schizophrenia.
  • Analysis of research on NMDA receptor-stimulating agents (e.g., glycine, d-serine, d-cycloserine) as adjunctive treatments.
  • Comparison of treatment outcomes focusing on negative symptoms and cognitive function.

Main Results:

  • Atypical antipsychotics demonstrate superior improvement in negative symptoms over conventional agents.
  • Adjunctive therapy with NMDA receptor agonists shows potential for significant additional reduction in negative and cognitive symptoms.
  • Further research is needed to clarify whether atypical antipsychotics address core negative symptoms or reduce secondary psychopathology.

Conclusions:

  • NMDA receptor-stimulating agents represent a promising therapeutic avenue for persistent negative and cognitive symptoms in schizophrenia.
  • Combination therapy with antipsychotics and NMDA agonists may offer enhanced benefits for schizophrenia patients.
  • Distinguishing between core and secondary symptoms remains crucial for targeted treatment development.

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