Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, Los Angeles, CAUSA.
Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, ILUSA.
Schizophr Bull. 2023 Sep 7;49(5):1161-1173. doi: 10.1093/schbul/sbad094.
Diminished social motivation is a negative symptom of schizophrenia and leads to severe functional consequences for many patients suffering from the illness. However, there are no effective medications available to treat this symptom. Despite the lack of approved treatments for patients, there is a growing body of literature on the effects of several classes of drugs on social motivation in healthy volunteers that may be relevant to patients. The aim of this review is to synthesize these results in an effort to identify novel directions for the development of medications to treat reduced social motivation in schizophrenia.
In this article, we review pharmacologic challenge studies addressing the acute effects of psychoactive drugs on social motivation in healthy volunteers and consider how these findings may be applied to deficits in social motivation in schizophrenia. We include studies testing amphetamines and 3,4-methylenedioxymethamphetamine (MDMA), opioids, cannabis, serotonergic psychedelics, antidepressants, benzodiazepines, and neuropeptides.
We report that amphetamines, MDMA, and some opioid medications enhance social motivation in healthy adults and may represent promising avenues of investigation in schizophrenia.
Given the acute effects of these drugs on behavioral and performance-based measures of social motivation in healthy volunteers, they may be particularly beneficial as an adjunct to psychosocial training programs in patient populations. It remains to be determined how these medications affect patients with deficits in social motivation, and in which contexts they may be most effectively administered.
社会动机减弱是精神分裂症的一种阴性症状,会给许多患病患者带来严重的功能后果。然而,目前还没有有效的药物可以治疗这种症状。尽管没有针对患者的批准治疗方法,但越来越多的文献研究了几类药物对健康志愿者社会动机的影响,这些影响可能与患者有关。本文的目的是综合这些结果,为开发治疗精神分裂症患者社会动机减退的药物寻找新的方向。
本文回顾了探讨精神活性药物对健康志愿者社会动机急性影响的药物挑战研究,并考虑了如何将这些发现应用于精神分裂症患者的社会动机缺陷。我们包括了测试安非他命和 3,4-亚甲基二氧甲基苯丙胺(MDMA)、阿片类药物、大麻、血清素致幻剂、抗抑郁药、苯二氮䓬类药物和神经肽的研究。
我们报告称,安非他命、MDMA 和一些阿片类药物可增强健康成年人的社会动机,这可能是精神分裂症研究的一个有前途的方向。
鉴于这些药物对健康志愿者行为和基于表现的社会动机测量的急性影响,它们可能特别有益于患者群体的心理社会训练计划的辅助治疗。这些药物如何影响社会动机缺陷的患者,以及在哪些情况下它们可能最有效地给药,仍有待确定。