A systematic review of psychostimulant treatment of negative symptoms of schizophrenia: Challenges and therapeutic opportunities

Lindenmayer, Jean-Pierre; Nasrallah, Henry A.; Pucci, Michael L.; James, Steven; Citrome, Leslie

doi:10.1016/j.schres.2013.03.019

Cited by 83 publications

(57 citation statements)

References 93 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For these reasons, this group of medications has not been systematically studied in these two disorders that essentially or commonly need antipsychotics. Most studies of stimulants in schizophrenia have used modafinil or armodafinil [110][111][112][113][114][115]. The most recent meta-analysis of randomized trials (pooled N = 372; median duration 8 weeks) concluded that modafinil or armodanifil (200 mg/d) had a significant effect on improvement of negative symptoms with small effect sizes.…”

Section: Using Stimulant and Stimulant-like Agentsmentioning

confidence: 99%

Antipsychotic Drug-Induced Somnolence: Incidence, Mechanisms, and Management

et al. 2016

View full text Add to dashboard Cite

Somnolence is a common side effect of antipsychotics. To assess the incidence of this side effect, we performed a MEDLINE search for randomized, double-blinded, placebo- or active-controlled studies of adult patients treated with antipsychotics for schizophrenia, mania, bipolar depression, or bipolar disorder. We extracted rates of somnolence from original publications and pooled them based on the dose of each antipsychotic in the same psychiatric condition, then estimated the absolute risk increase (ARI) and the number needed to harm (NNH) of an antipsychotic relative to placebo or an active comparator in the same psychiatric condition. According to the ARI in acute schizophrenia, bipolar mania, and bipolar depression, antipsychotics can be classified as high somnolence (clozapine), moderate somnolence (olanzapine, perphenazine, quetiapine, risperidone, ziprasidone), and low somnolence (aripiprazole, asenapine, haloperidol, lurasidone, paliperidone, cariprazine). The risk of somnolence with blonanserin, brexpiprazole, chlorpromazine, iloperidone, sertindole, and zotepine needs further investigation. The rates of somnolence were positively correlated to dose and duration for some antipsychotics, but not for others. Many factors, including antipsychotic per se, the method used to measure somnolence, patient population, study design, and dosing schedule, might affect the incidence of antipsychotic-induced somnolence. The mechanisms of antipsychotic-induced somnolence are likely multifactorial, although the blockade of histamine 1 receptors and α1 receptors may play a major role. The management of antipsychotic-induced somnolence should include sleep hygiene education, choosing an antipsychotic with a lower risk for somnolence, starting at a lower dose with a slower titration based on psychiatric diagnoses, adjusting doses when necessary, and minimizing concurrent somnolence-prone agents. Since most cases of somnolence were mild to moderate, allowing tolerance to develop over at least 4 weeks is reasonable before discontinuing an antipsychotic.

show abstract

Section: Using Stimulant and Stimulant-like Agentsmentioning

confidence: 99%

Antipsychotic Drug-Induced Somnolence: Incidence, Mechanisms, and Management

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In fact, in rat studies, VPA increased extracellular DA levels in the mPFC, likely mediated by indirect activation of 5-HT-1A receptors (28,29). This mechanism is believed to improve cognition and negative symptoms in psychotic disorders (30).…”

Section: Dopamine (Da)mentioning

confidence: 96%

Valproic Acid for Treatment of Hyperactive or Mixed Delirium: Rationale and Literature Review

et al. 2015

View full text Add to dashboard Cite

“…However, in this study participant numbers were low (23 drug v. 23 placebo) and the researchers concluded that larger controlled trials are needed before recommendation for a broad clinical application can be made. A systematic review of psychostimulants to treat negative symptoms of schizophrenia concluded that large controlled trials to characterise the effects of psychostimulants in clearly defined schizophrenia patient groups are required [23].…”

Section: Modafinil and Schizophreniamentioning

confidence: 99%

The Effects of Modafinil in People with a Diagnosis of Schizophrenia

Griffiths¹,

Girardi²

2018

OJPsych

View full text Add to dashboard Cite

This review seeks to describe the use and effects of the drug modafinil. Specifically, it presents the research of the impact of modafinil for people with diagnosis and experience of schizophrenia. Recent reviews have shown that modafinil can positively impact on cognitive function in people with a diagnosis of schizophrenia. There is emerging evidence for the positive impact of modafinil on negative symptoms, functioning, quality of life, wellbeing, and body mass index (BMI) for people with schizophrenia. Compared to other central nerve stimulant (CNS) drugs, modafinil has a low risk of dependency and few negative side effects; but there are risks of triggering positive symptoms in schizophrenia. A well designed and sufficiently large randomised control trial is required to test the potential of the impact of modafinil in the lives of people with a diagnosis of schizophrenia. Future research should report participant's perspective of the value of modafinil connected to what concerns them and what they want to achieve in their lives.

show abstract

A systematic review of psychostimulant treatment of negative symptoms of schizophrenia: Challenges and therapeutic opportunities

Cited by 83 publications

References 93 publications

Antipsychotic Drug-Induced Somnolence: Incidence, Mechanisms, and Management

Antipsychotic Drug-Induced Somnolence: Incidence, Mechanisms, and Management

Valproic Acid for Treatment of Hyperactive or Mixed Delirium: Rationale and Literature Review

The Effects of Modafinil in People with a Diagnosis of Schizophrenia

Contact Info

Product

Resources

About