Efficacy of amisulpride in treating primary negative symptoms in first-episode psychosis: a pilot study

Negative symptoms are debilitating and associated with poor role functioning and reduced quality of life. There is a paucity of research on antipsychotic efficacy against the primary negative symptoms, particularly in first-episode psychosis (FEP). We undertook a prospective, open-label pilot trial to investigate the use of amisulpride in the treatment of young people with FEP characterised by primary negative symptoms.

Twelve male and two female first-episode patients with primary negative symptoms (aged 16-26) were commenced on low-dose amisulpride (mean 250 mg/day) and followed-up over a 6-month period. Primary outcome measures were the Scale for the Assessment of Negative Symptoms (SANS), the Quality of Life Survey (QLS) and their respective subscales.

For the 12 completers there was a statistically significant improvement in SANS summary score (p = 0.036), Affective Flattening subscale global score (p = 0.046), QLS total score (p = 0.021), QLS subscales of Instrumental Role (p = 0.018) and Intra-psychic Foundations (p = 0.009) from baseline to week 24.

Amisulpride appears to be associated with less severe negative symptoms and improved quality of life. Generalisabilty of the findings is limited by the small sample size and open-label design of our study, however the positive findings suggest that further controlled trials are warranted.