Brasso Claudio, Colli Gianluca, Sgro Rodolfo, Bellino Silvio, Bozzatello Paola, Montemagni Cristiana, Villari Vincenzo, Rocca Paola
Department of Neuroscience "Rita Levi Montalcini", University of Turin, 10124 Torino, Italy.
Psychiatric Emergency Service, Department of Neuroscience and Mental Health, Azienda Ospedaliero-Universitaria "Città della Salute e della Scienza di Torino", 10126 Turin, Italy.
Biomedicines. 2023 Mar 16;11(3):921. doi: 10.3390/biomedicines11030921.
Schizophrenia is among the fifteen most disabling diseases worldwide. Negative symptoms (NS) are highly prevalent in schizophrenia, negatively affect the functional outcome of the disorder, and their treatment is difficult and rarely specifically investigated. Serotonin-dopamine activity modulators (SDAMs), of which aripiprazole, cariprazine, brexpiprazole, and lumateperone were approved for schizophrenia treatment, represent a possible therapy to reduce NS. The aim of this rapid review is to summarize the evidence on this topic to make it readily available for psychiatrists treating NS and for further research. We searched the PubMed database for original studies using SDAM, aripiprazole, cariprazine, brexpiprazole, lumateperone, schizophrenia, and NS as keywords. We included four mega-analyses, eight meta-analyses, two post hoc analyses, and 20 clinical trials. Aripiprazole, cariprazine, and brexpiprazole were more effective than placebo in reducing NS. Only six studies compared SDAMs with other classes of antipsychotics, demonstrating a superiority in the treatment of NS mainly for cariprazine. The lack of specific research and various methodological issues, related to the study population and the assessment of NS, may have led to these partial results. Here, we highlight the need to conduct new methodologically robust investigations with head-to-head treatment comparisons and long-term observational studies on homogeneous groups of patients evaluating persistent NS with first- and second-generation scales, namely the Brief Negative Symptom Scale and the Clinical Assessment Interview for Negative Symptoms. This rapid review can expand research on NS therapeutic strategies in schizophrenia, which is fundamental for the long-term improvement of patients' quality of life.
精神分裂症是全球十五种最具致残性的疾病之一。阴性症状（NS）在精神分裂症中非常普遍，对该疾病的功能结局产生负面影响，并且其治疗困难且很少有专门研究。血清素 - 多巴胺活性调节剂（SDAMs），其中阿立哌唑、卡立哌嗪、布雷斯哌唑和鲁马哌酮已被批准用于精神分裂症治疗，是一种可能减少阴性症状的疗法。本快速综述的目的是总结关于该主题的证据，以便治疗阴性症状的精神科医生能够 readily available 获取并用于进一步研究。我们在PubMed数据库中搜索了以SDAM、阿立哌唑、卡立哌嗪、布雷斯哌唑、鲁马哌酮、精神分裂症和阴性症状为关键词的原始研究。我们纳入了四项荟萃分析、八项元分析、两项事后分析和20项临床试验。阿立哌唑、卡立哌嗪和布雷斯哌唑在减少阴性症状方面比安慰剂更有效。只有六项研究将SDAMs与其他类别的抗精神病药物进行了比较，表明主要是卡立哌嗪在阴性症状治疗方面具有优势。与研究人群和阴性症状评估相关的缺乏具体研究和各种方法学问题可能导致了这些部分结果。在此，我们强调需要进行新的方法学严谨的研究，进行头对头治疗比较以及对同质患者群体进行长期观察性研究，使用第一代和第二代量表，即简明阴性症状量表和阴性症状临床评估访谈来评估持续性阴性症状。本快速综述可以扩展对精神分裂症阴性症状治疗策略的研究，这对于长期改善患者生活质量至关重要。 （注：“readily available”直译为“随时可用”，结合语境这里意译为“能够 readily available 获取”，表述更通顺些，但严格按要求未添加解释说明）
