Perera Pradilka, Gajaram Ganeya, Qureshi Danish, Gill Manpreet, Thanju Amod, Zaman Afrina, Fouron Patrice, Jolayemi Ayodeji
Psychiatry, Interfaith Medical Center, Brooklyn, USA.
Psychiatry, Medical University of the Americas / Interfaith Medical Center, Brooklyn, USA.
Cureus. 2022 Mar 26;14(3):e23518. doi: 10.7759/cureus.23518. eCollection 2022 Mar.
Antipsychotic treatment has been documented as the mainstay for the management of schizophrenia. Evidence in literature has suggested that the management of negative symptoms of schizophrenia continues to be a treatment challenge. Therefore, residual negative symptoms can become more pervasive and visible after the treatment of positive symptoms, leading to an impaired marked deficit in the vital daily functions of patients. We present a case series of three patients with a past psychiatric history of schizophrenia who presented to the psychiatric emergency with acute symptoms of schizophrenia. Following antipsychotic treatment, all these patients showed improvement of positive symptoms, however, profound negative symptoms of schizophrenia became visible. The negative symptoms include anhedonia, amotivation, alogia, affective flattening, and passive social withdrawal. We added bupropion to manage the negative symptoms, and all three patients achieved a good treatment response. This case series suggests that the anti-depressive effects of bupropion might be a valuable treatment option in the treatment of negative symptoms of schizophrenia.
抗精神病药物治疗已被证明是精神分裂症管理的主要手段。文献证据表明,精神分裂症阴性症状的管理仍然是一个治疗挑战。因此,在阳性症状得到治疗后,残留的阴性症状可能会变得更加普遍和明显,导致患者重要日常功能出现明显受损。我们呈现了一个包含三名患者的病例系列,这三名患者既往有精神分裂症病史,因精神分裂症急性症状就诊于精神科急诊。经过抗精神病药物治疗后,所有这些患者的阳性症状均有所改善,然而,精神分裂症的严重阴性症状却变得明显。阴性症状包括快感缺失、动机缺乏、言语减少、情感平淡和社交退缩。我们加用安非他酮来管理阴性症状,所有三名患者均取得了良好的治疗反应。这个病例系列表明,安非他酮的抗抑郁作用可能是治疗精神分裂症阴性症状的一个有价值的治疗选择。