Abstract
Negative symptoms have a significant negative impact on functional capacity of schizophrenia patients; management of negative symptom is one of the unmet needs. So far, there is no effective and reliable treatment of negative symptoms available.
Most of the data are based on the post-hoc analyses of short-term studies, where negative symptoms were not the primary efficacy measure, with no distinction between primary and secondary symptoms. In this paper, we review all pharmacological approaches in the management of negative symptoms in schizophrenia.
Antipsychotics with the most robust evidence are amisulpride and cariprazine, with small to moderate effect size in monotherapy. Cariprazine was superior to risperidone in treatment of predominant negative symptoms of schizophrenia.
Other pharmacological options are adjuvant treatment of antipsychotics with aripiprazole, glutamatergic agents (topiramate, memantine), or antidepressants (SSRI, NaSSA ). Non-pharmacological alternative interventions can be used, as well, e.g., high-frequency repetitive transcranial magnetic stimulation administered over the dorsolateral prefrontal cortex, physical exercise, cognitive-behavioral therapy, cognitive remediation.