Davis Michael C, Horan William P, Marder Stephen R
Department of Veterans Affairs, VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA; UCLA Semel Institute of Neuroscience and Human Behavior, Los Angeles, CA, USA.
Department of Veterans Affairs, VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA.
Eur Neuropsychopharmacol. 2014 May;24(5):788-99. doi: 10.1016/j.euroneuro.2013.10.010. Epub 2013 Nov 4.
The past decade has witnessed a resurgence of interest in the development of novel pharmacological agents to treat the negative symptoms of schizophrenia. This review provides an overview of pharmacological approaches that have been evaluated as potential treatments and describes the emergence of several promising new approaches. First, we briefly describe recent methodological developments, including consensus-based clinical trial guidelines for patient selection criteria, symptom assessment, and trial duration. Next, we overview mono- and adjunctive-therapies that have been evaluated, including first- and second-generation antipsychotics, antidepressants, psychostimulants, molecules targeting cholinergic and glutamatergic systems, and hormones. We highlight the most promising pharmacological agents on the horizon, including glycine transporter-1 inhibitors, α7-nicotinic receptor positive allosteric modulators, and oxytocin, as well as non-pharmacological electromagnetic stimulation approaches. Further investigations, using optimal clinical trial design, hold considerable promise for discovering effective treatments for these functionally disabling symptoms in the near future.
在过去十年里,人们对开发治疗精神分裂症阴性症状的新型药物重新产生了兴趣。本综述概述了已被评估为潜在治疗方法的药理学途径,并描述了几种有前景的新方法的出现。首先,我们简要介绍了近期的方法学进展,包括基于共识的临床试验指南,用于患者选择标准、症状评估和试验持续时间。接下来,我们概述了已被评估的单一疗法和辅助疗法,包括第一代和第二代抗精神病药物、抗抑郁药、精神兴奋剂、靶向胆碱能和谷氨酸能系统的分子以及激素。我们重点介绍了即将出现的最有前景的药物,包括甘氨酸转运体-1抑制剂、α7-烟碱受体正向变构调节剂和催产素,以及非药物电磁刺激方法。采用最佳临床试验设计进行的进一步研究,有望在不久的将来发现针对这些功能致残症状的有效治疗方法。