Moccia Lorenzo, Bardi Francesca, Anesini Maria Benedetta, Barbonetti Sara, Kotzalidis Georgios D, Rossi Sara, Caso Romina, Grisoni Flavia, Mandracchia Giuseppe, Margoni Stella, Callovini Tommaso, Janiri Delfina, Mazza Marianna, Simonetti Alessio, Montanari Silvia, Autullo Gianna, Camardese Giovanni, Pepe Maria, Di Nicola Marco, Di Giorgio Vassilij, Conti Fabio, Sani Gabriele
Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy.
Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy.
Biomedicines. 2025 Feb 21;13(3):540. doi: 10.3390/biomedicines13030540.
While positive symptoms of schizophrenia are often satisfactorily controlled, negative symptoms are difficult to treat, persisting despite treatment. Different strategies have been devised to deal with this problem. We aimed to review drug treatment for negative symptoms of schizophrenia in controlled trials of marketed drugs. We searched the PubMed database and the resulting records' reference lists to identify eligible trials using schizophrenia[ti] AND "negative symptom*"[ti] as a search strategy. We determined eligibility through Delphi rounds among all authors. On 11 February 2025, we identified 1485 records on PubMed and 3 more from reference lists. Eligible were 95 records. Most studies were double-blind, randomized controlled trials, carried-out in add-on in patients stabilized with antipsychotics. Other antipsychotics were the most frequent comparators, followed by antidepressants, and recently, antioxidants are gaining importance in trials. Many trials, especially those conducted in the Western world, found no significant effects compared to placebo, while most Iranian studies were positive, although not with a strong effect size. Current research has contributed little to progress in the treatment of the negative symptoms of schizophrenia. The reason might reside in the absence of knowledge of the mechanisms whereby these symptoms are generated, which prevents us from designing possibly effective treatment strategies, and/or to the chronicity of negative symptoms, as they are the first to be established even when they do not become fully apparent.
虽然精神分裂症的阳性症状通常能得到令人满意的控制，但阴性症状却难以治疗，即便经过治疗仍会持续存在。人们已经制定了不同的策略来应对这一问题。我们旨在回顾在市售药物的对照试验中针对精神分裂症阴性症状的药物治疗情况。我们检索了PubMed数据库以及所得记录的参考文献列表，以“精神分裂症[标题] AND ‘阴性症状*’[标题]”作为检索策略来识别符合条件的试验。我们通过所有作者之间的德尔菲轮次来确定入选资格。2025年2月11日，我们在PubMed上识别出1485条记录，从参考文献列表中又找到3条。符合条件的有95条记录。大多数研究是双盲随机对照试验，在使用抗精神病药物稳定病情的患者中进行附加治疗。其他抗精神病药物是最常见的对照药物，其次是抗抑郁药，最近抗氧化剂在试验中的重要性也在增加。许多试验，尤其是在西方世界进行的试验，与安慰剂相比未发现显著效果，而大多数伊朗的研究结果是阳性的，尽管效应量不强。目前的研究对精神分裂症阴性症状治疗的进展贡献不大。原因可能在于缺乏对这些症状产生机制的了解，这使得我们无法设计出可能有效的治疗策略，和/或在于阴性症状的慢性特点，因为即使它们没有完全显现出来，也是最早出现的症状。
