Antidepressants for the negative symptoms of schizophrenia

Rummel, Christine; Kissling, Werner; Leucht, Stefan

doi:10.1002/14651858.cd005581.pub2

Cited by 48 publications

(22 citation statements)

References 125 publications

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“…Однако опыт их использования пока доволь-но мал. Получены данные, что терапия современными ан-тидепрессантами в большей степени ослабляет аффектив-ные проявления негативной симптоматики, чем волевые нарушения [33]. Эффективность терапии первыми поко-лениями антидепрессантов -ТЦА и ИМАО -связывалась с их симптоматическим стимулирующим эффектом [27,28].…”

Section: о б з о р ыunclassified

“…Например, дан-ные C. Rummel-Kluge и соавт. [33], опубликованные в сис-тематическом Кокрейновском обзоре в 2006 г., свидетельст-вуют лишь о предположительной эффективности антиде-прессантов (амитриптилин, миансерин, тразадон, пароксе-тин, флувоксамин и флуоксетин). Данные, полученные в 2010 г. английскими психиатрами S. Singh и соавт.…”

Section: о б з о р ыunclassified

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The rationale for antidepressants in the treatment of schizophrenia: A modern view on the problem in the context of evidence-based medicine

Данилов

Magomedova

Matsneva

2016

RJTAO

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Вопрос о рациональности лечения больных шизофренией антидепрессантами (в комбинации с нейролептиками) явля-ется предметом многолетней дискуссии. С момента первых попыток применения такой терапии исследователи делятся на ее сторонников и противников. Несмотря на это, лечение шизофрении антидепрессантами получило очень широкое распространение. Результаты отечественных и зарубежных исследований свидетельствуют о том, что антидепрессанты используются более чем у 30-50% больных [1][2][3]. Обычно комбинированная терапия (антидепрессантами и нейролеп-тиками) проводится больным с депрессивной симптомати-кой, негативными расстройствами и продуктивными сим-птомами неаффективного круга 1 . Настоящий аналитический обзор посвящен оценке доказанности эффективности при-менения антидепрессантов при лечении этих групп больных шизофренией на основании обобщения данных, имеющихся в настоящее время. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, neuropsychiatry, psychosomatics. 2016;(8)1:71-81. DOI: http://dx.doi.org/10.14412/2074(8)1:71-81. DOI: http://dx.doi.org/10.14412/ -2711(8)1:71-81. DOI: http://dx.doi.org/10.14412/ -2016 Обоснованность применения антидепрессантов при лечении шизофрении (современный взгляд на проблему с позиции доказательной медицины)1 Иногда антидепрессанты пытаются применять для коррекции по-бочных эффектов нейролептической терапии. Обсуждение этого вопроса оставлено за рамками настоящей статьи.

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Section: о б з о р ыunclassified

The rationale for antidepressants in the treatment of schizophrenia: A modern view on the problem in the context of evidence-based medicine

Данилов

Magomedova

Matsneva

2016

RJTAO

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“…Another rigorous Cochrane systematic review reached a similar conclusion, but cautioned that given only five of 139 studies met the required standards to evaluate the effect on potential confounding symptoms (for example, depressive and positive symptoms), treatment response may have been misattributed to another cause for the symptoms. This methodological concern was addressed earlier and remains problematic for many published studies in negative symptoms 69. Nonetheless, other meta-analyses of agents with antidepressant properties – alpha-2 receptor antagonists (mianserin, mirtazapine) and Ginkgo biloba (thought to increase synaptic serotonin) – also showed potential as adjunctive therapy for schizophrenia 68,70.…”

Section: Existing Pharmacological Treatment Of Negative Symptomsmentioning

confidence: 99%

Addressing the unmet needs of patients with persistent negative symptoms of schizophrenia: emerging pharmacological treatment options

Chue¹,

Lalonde

2014

NDT

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The negative symptoms of schizophrenia represent an impairment of normal emotional responses, thought processes and behaviors, and include blunting or flattening of affect, alogia/aprosody, avolition/apathy, anhedonia, and asociality. Negative symptoms contribute to a reduced quality of life, increased functional disability, increased burden of illness, and poorer long-term outcomes, to a greater degree than positive symptoms. Primary negative symptoms are prominent and persistent in up to 26% of patients with schizophrenia, and they are estimated to occur in up to 58% of outpatients at any given time. Negative symptoms respond less well to medications than positive symptoms, and to date treatment options for negative symptoms have been limited, with no accepted standard treatment. Modest benefits have been reported with a variety of different agents, including second-generation antipsychotics and add-on therapy with antidepressants and other pharmacological classes. Recent clinical research focusing on negative symptoms target novel biological systems, such as glutamatergic neurotransmission. Different approaches include: enhancing N-methyl-D-aspartate receptor function with agents that bind directly to the glycine ligand site or with glycine reuptake inhibitors; influencing the metabotropic glutamate receptor (mGluR2/3) with positive allosteric modulators; and stimulating nicotinic acetylcholine receptors. In conclusion, the lack of clearly efficacious pharmacological treatments for the management of negative symptoms represents a significant unmet need, especially considering the importance of these symptoms on patient outcomes. Hence, further research to identify and characterize novel pharmacological treatments for negative symptoms is greatly needed.

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“…[19][20][21] These were all relatively circumspect in their conclusions, partly reflecting that most of the relevant studies have been characterised by small sample sizes, failure to control for change in secondary negative symptoms, and a relatively short duration considering the long term nature of the problem being treated.…”

mentioning

confidence: 99%

“…The earliest review was a Cochrane review, 19 which included five randomised controlled trials. It found significant differences in favour of antidepressant augmentation in reducing core negative symptoms and concluded that these differences were promising enough to justify conducting large, pragmatic, well designed, long term trials in this area.…”

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confidence: 99%