Effect of Pimozide on Positive and Negative Symptoms in Schizophrenic Patients: Are Negative Symptoms State Dependent?

Abstract

In a double-blind, placebo-controlled trial of treatment with the neuroleptic pimozide, negative symptoms improved in schizophrenic patients who showed an antipsychotic response. Furthermore, there was a significant positive correlation between changes in positive and negative symptoms for the group as a whole, including both pimozide responders and nonresponders. In our patient sample, neuroleptic treatment did not exert a differential effect on the positive and negative symptoms of schizophrenia. It is conceivable that negative symptoms are state dependent and may become neuroleptic nonresponsive over time just as positive symptoms do in some chronic patients.

Covariance of positive and negative symptoms during neuroleptic treatment in schizophrenia: A replication

“…In agreement with the findings of other recent studies (Breier et al 1987;vanKammen et al 1987;Kay and Singh 1989;Tandon et al 1990;Meltzer, 1990;Serban et ai 1992), these data confirm that both positive and negative symptoms improve significantly with neuroleptic treatment, Similar to the findings of these studies, we observed that positive symptoms improved to a greater extent than negative symptoms, The significant correlation between change in positive and negative symptoms noted in this study is in agreement with our previous study and the findings of vanKammen et al (I 987) and Meltzer (1990), but inconsistent with Breier et al (1987) and Serban et ai, (1992), who did not find such a relationship, I~reicr et al's inability to find this relationship may have been related to their relatively small sample size (19), Serban et al (1992) studied a sample of "negative schizophrenics" and excluded patients with more than moderate positive symptoms; their ability to detect covariance between positive and negative symptoms may have been limited by the restricted range of positive symptoms in their sample, Meltzer (1990) noted covariance of positive and negative symptoms in the course of treatment of schizophrenic patients with typical neureleptics but not with clozapine,…”

“…Although poor response to neuroleptics has traditionally been considered a characteristic feature of negative schizophrenic symptoms (Crow 1980;Andreasen et aJ 1982), several recent studies have documented significant improvement in negative symptoms in schizophrenic patients treated with neuroleptics (Breier et al 1987;vanKammen et al 1987;Kay and Singh 1989;Tendon et al 1990;Meltzer, 1990, Serban et al 1992. The question of whether neuroleptic-induced improvement in negative symptoms is linked to concomitant improvement in positive symptoms (vanKammen et al 1987;Tendon et al 1990;Meltzer 1990) or occurs independently of such improvement (Breier et al 1987;Serban et al 1992) is unresolved. This issue has obvious pathophysiological and therapeutic relevance.…”

Negative symptoms: a path analytic approach to a double-blind, placebo- and haloperidol-controlled clinical trial with olanzapine

“…Evidence suggests that when typical neuroleptics are initially effective, they may appear to reduce both the positive and negative symptoms of schizophrenia (21)(22)(23)(24)(25)(26). However, conventional neuroleptics reportedly fail to provide a sustained reduction in primary or deficit negative symptoms for the majority of patients (27).…”

Positive and Negative Symptoms: Is Their Change Related?

“…Studies examining the acute phase, with a time span of several weeks, raised the possibility of short-term association, but remained inconclusive. Taken together—from no relationship (Breier et al 1987; Serban et al 1992) to strong positive association (van Kammen et al 1987; Tandon et al 1990, 1993)—variable findings have been reported. However, the results of these studies are hard to interpret because of certain design limitations.…”