Schizophrenia and Negative Symptoms: Q&A with Dr. Potkin

May 20, 2013 at 7:48 pm | Posted in 2013, Abilify, affective flattening, alogia, Anti-anxiety meds, Anti-depressants, Anti-psychotics, asociality, avolition, Biology, Bipolar, Brain, Depakote, Depression, dopamine hypothesis, Dr. Steven G. Potkin, drugs, Education, Genentech, Geodon, Haldol, Haldol DEC, Haldol Decanoate, Health, insanity, Irvine (UCI), Kristin Bell, Lithium, Mania, Manic, Medicine, Mental Health, Mental Illness, Mood Stabilizers, N-methyl-D-aspartate, NAMI, negative symptoms, neuron, neuroscience, neurotransmitters, NMDA, NMDA receptor hypofunction hypothesis, Paranoid Schizophrenia, Paxil, Prescription Meds, Psych Meds, Psychiatrist, Psychiatry, Psychiatry Denial, Psycho, Psychoactive Substances, psychoanalysis, Psychology, Psychosis, Risperdal, schizoaffective disorder, Schizophrenia, Science, Seroquel, stigma, Support System, Surviving, symptoms, synapse, sz, Therapist, Trazadone, treatment, treatment-resistant, Trilifon, Wellbutrin, Zoloft, Zyprexa | Leave a comment

negsymp I have some great news! I was able to ask Dr. Steven G. Potkin, Professor of Psychiatry in the Department of Psychiatry and Human Behavior at the University of California, Irvine (UCI) Medical Center, some questions regarding the negative symptoms of schizophrenia. He is also the Robert R. Sprague Endowed Chair in Brain Imaging. It was a brief, by email interview, but I’m happy to share what I’ve learned with you all! The following is the Q&A:

Kristin: What are negative symptoms?
Dr. Potkin: “Negative” does not refer to a person’s attitude, but instead to a lack of characteristics that should be present. Symptoms include reduced amount and content of speech, even when encouraged to interact (alogia), lack of emotional and facial expression (affective flattening), diminished ability to begin and sustain activities (avolition), decreased ability to find pleasure in everyday life (anhedonia) and social withdrawal (asociality). [1] [2]

Negative symptoms can appear a few years before other symptoms appear in young adulthood in the so-called “prodromal” stage of the illness.[3] Unfortunately these symptoms often go undetected because they manifest themselves as issues common among teenagers: social withdrawal, problems with school work, irritability, depression and sleeping problems.[4]

Kristin: Do all people with schizophrenia have negative symptoms?
Dr. Potkin: No, but at any point in time, negative symptoms can affect approximately 50 percent or more of people with schizophrenia.[5] [6]

Kristin: How do negative symptoms affect a person with schizophrenia? How do they affect their family and friends?
Dr. Potkin: Research suggests that for people living with schizophrenia, negative symptoms are key factors in poor quality of life as well as problems with personal hygiene, school and work performance, maintaining relationships, interacting within the community, and participating in social activities. [7] [8] [9] [10]

For caregivers of people with schizophrenia, negative symptoms may cause more burden than do other types of symptoms as they see their loved ones life isolated and lacking in meaning or joy. [11]

Kristin: How are negative symptoms currently treated?
Dr. Potkin: Current treatments for schizophrenia focus on reducing characteristic symptoms and can include both medication and psychosocial interventions.[12] No effective medication treatment has yet been approved for specific treatment of negative symptoms. Despite progress in the medication side of treatment, there are still unmet needs in terms of symptom control. A large study found that despite treatment, approximately 57 percent of people receiving treatment for a schizophrenia spectrum disorder still had at least one negative symptom.[10]

Kristin: What is the research that Genentech is doing regarding negative symptoms?
Dr. Potkin: Researchers at Genentech are pursuing new treatment strategies for schizophrenia, including increasing N-methyl-D-aspartate (NMDA) receptor activity in the brain in order to target the mechanism that may be a common link between the positive, negative and cognitive symptoms of the disorder.[7] [9] [11] [12]

Specifically, through a clinical trial program, Genentech is looking at an investigational medication for people with schizophrenia, including people who experience mostly negative symptoms of schizophrenia, despite taking medication. For more information, please visit www.SearchLyteschizophrenia.com

Kristin: How can family and friends of someone with schizophrenia help someone with negative symptoms?
Dr. Potkin: Caregivers can talk to doctors about interventions including medication, psychosocial rehabilitation (work, school, relationships), medical care and wellness, and therapy (e.g. cognitive behavioral therapy and peer support groups), as well as ongoing clinical trials.[13] They can work with physicians to find the medications and non-medicine therapies that are right for their loved one. Different medicines may have different side effects. Caregivers can also consider programs from the National Alliance on Mental Illness (NAMI) including:

• NAMI Hearts and Minds

– Online, interactive wellness initiative

www.nami.org/heartsandminds

• NAMI Peer-to-Peer

– Free, 9-week educational course on recovery

www.nami.org/peertopeer

• NAMI Connection

– Recovery support group for adults

www.nami.org/connection

Kristin: Do scientists know the biological mechanisms involved in negative symptoms? If so, what are the areas of the brain and/or mechanisms involved in negative symptoms?
Dr. Potkin: In the 1970s, the “dopamine hypothesis” of schizophrenia emerged, suggesting the biological basis of schizophrenia was an excess of signaling by dopamine, a chemical messenger in the brain. This theory, however, could not explain negative or cognitive symptoms.[6] In the late 1980’s a newer theory suggested positive, negative and cognitive symptoms could all be due to reduced function of NMDA receptors in the brain. This theory is now known as the “NMDA receptor hypofunction hypothesis.”[6] [7] [8] [9]

Researchers are pursuing new treatment strategies for schizophrenia, including increasing NMDA receptor function in the brain in order to target the mechanism that may be a common link between the positive, negative and cognitive symptoms of the disorder.[7] [9] [11] [12] It is thought that NMDA receptor activity is an important pathway in psychiatric disorders, especially schizophrenia.

End of article.

*Note: I would like to thank Dr. Potkin for helping me put together this interview. This research is very exciting and I hope that negative symptoms can be tackled in this decade! I know how debilitating they can be!

______________________________

1.     Gard DE, Kring AM, Gard MG, Horan WP, Green MF. Anhedonia in schizophrenia: distinctions between anticipatory and consummatory pleasure. Schizophr Res. Jul 2007;93(1-3):253-260.

2.     Strauss GP, Gold JM. A new perspective on anhedonia in schizophrenia. Am J Psychiatry. Apr 2012;169(4):364-373.

3.     Stahl SM. Stahl’s Essential Psychopharacology: Neuroscientific Basis and Practical Applications. 3rd ed. New York: Cambridge University Press; 2008.

4.     National Institute of Mental Health. Schizophrenia. 2009; http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml. Accessed July 7, 2012.

5.     Kirkpatrick B, Fenton WS, Carpenter WT, Jr., Marder SR. The NIMH-MATRICS consensus statement on negative symptoms. Schizophr Bull. Apr 2006;32(2):214-219.

6.     Bobes J, Arango C, Garcia-Garcia M, Rejas J. Prevalence of negative symptoms in outpatients with schizophrenia spectrum disorders treated with antipsychotics in routine clinical practice: findings from the CLAMORS study. J Clin Psychiatry. Mar 2010;71(3):280-286.

7.     Ho BC, Nopoulos P, Flaum M, Arndt S, Andreasen NC. Two-year outcome in first-episode schizophrenia: predictive value of symptoms for quality of life. Am J Psychiatry. Sep 1998;155(9):1196-1201.

8.     Kirkpatrick B, Fenton WS, Carpenter WT, Jr., Marder SR. The NIMH-MATRICS consensus statement on negative symptoms. Schizophr Bull. Apr 2006;32(2):214-219.

9.     Kurtz MM. Symptoms versus neurocognitive skills as correlates of everyday functioning in severe mental illness. Expert Rev Neurother. Jan 2006;6(1):47-56.

10.   Milev P, Ho BC, Arndt S, Andreasen NC. Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up. Am J Psychiatry. Mar 2005;162(3):495-506.

11.   Provencher HL, Mueser KT. Positive and negative symptom behaviors and caregiver burden in the relatives of persons with schizophrenia. Schizophr Res. Jul 25 1997;26(1):71-80.

12.   National Institute of Mental Health. Schizophrenia. 2009; http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml. Accessed July 7, 2012.

13.   National Institute of Mental Health. Schizophrenia. 2009; http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml. Accessed July 7, 2012.

The Fat Skeleton in the Closet

October 29, 2008 at 4:18 am | Posted in Anorexia, Binge Eating, Body, Body Image, Bulimia, Compulsive Eating, Compulsive Exercising, Counselor, Eating Disorders, EDNOS, Extended Plus Size, Fat, Fat Acceptance, Fat Hatred, Food, Health, Kristin Bell, Mental Health, Mental Illness, Obsessions, Psychiatry, Scales, Secrecy, Surviving, Therapist, Thin, Weight, Weightloss, Weightloss Industry | 2 Comments

I don’t talk that much about my eating disordered self. My eating disordered self is like the proverbial (fat) skeleton in the closet! Okay, I know skeletons aren’t fat, but mine is! haha. People tend to think one of two things when you are fat. They either think that you don’t have an eating disorder and that you are just lazy, gluttonous, disgusting, and everything else along those lines…OR if they don’t think that, they think you DO have an eating disorder and the eating disorder is OBESITY period. So, basically Continue Reading The Fat Skeleton in the Closet…

I Feel For Ya, Britney!

January 31, 2008 at 9:43 am | Posted in Anti-anxiety meds, Anti-depressants, Anti-psychotics, Bipolar, Britney Spears, Bulimia, Buspar, Drama, Kristin Bell, Lithium, Mania, Manic, Manic-Depressive, Medicine, Mental Health, Mental Illness, Mood Stabilizers, Prescription Meds, Problems, Psych Meds, Psychiatrist, Psychiatry, Psychiatry Denial, Psycho, Psychosis, Schizophrenia, Support System, Surviving, Therapist | 6 Comments
bald britney

Okay, I rarely write about celebrity gossip, but overnight Britney Spears was taken into the hospital for psychiatric evaluation and I guess I feel the need to comment. From what I’ve heard on the news, she hasn’t slept since Saturday and she’s now on a 72-hour hold. I have also been Continue Reading I Feel For Ya, Britney!…

A Book Everyone Should Read!

December 24, 2007 at 3:06 pm | Posted in Acceptance, Activism, Anti-anxiety meds, Anti-depressants, Anti-psychotics, Bipolar, Books, Counselor, Discrimination, Elyn R. Saks, Geodon, Haldol, Haldol DEC, Haldol Decanoate, Kristin Bell, Lunatic, Medicine, Mental Health, Mental Illness, Navane, NIMH, Prescription Meds, Problems, Psych Meds, Psychiatrist, Psychiatry, Psychiatry Denial, Psycho, Psychosis, Reading, Risperdal, Schizophrenia, Seroquel, Surviving, The Center Cannot Hold, Therapist, Trazadone, Trilifon | Leave a comment
saksbook

I just finished reading Elyn R. Saks’ book, The Center Cannot Hold, and I highly recommend it to everyone, especially people who are touched by someone who has mental illness. The book is a memoir of Ms. Saks’ life and coming to terms with schizophrenia. From an early age she recalls having strange thoughts, but Continue Reading A Book Everyone Should Read!…

Schizophrenia Research I’m Participating In

December 2, 2007 at 6:32 pm | Posted in Acceptance, Amblify, Anti-anxiety meds, Anti-depressants, Anti-psychotics, Anxiety, Family, Fun, Geodon, Haldol, Haldol DEC, Haldol Decanoate, Kristin Bell, Lunatic, Measurements, Medicine, Mental Health, Mental Illness, Mood Stabilizers, NIMH, Prescription Meds, Problems, Psych Meds, Psychiatrist, Psychiatry, Psychiatry Denial, Psycho, Psychosis, Research, Risperdal, Schizophrenia, Support System, Surviving, Therapist, Tips & Tricks, Trazadone, Trilifon, Zoloft, Zyprexa | 4 Comments

eye tracking

You might be asked to participate in an eye tracking exercise like the one shown above. All of the equipment is just used to keep your head still and to track your eyes.

 —————————

I just wanted to let you all know about this schizophrenia research study I am most likely going to be participating in and I hope that if any of you out there are interested, you will join in on the study! Well, as you might know, I got a new job at schizophrenia.com. Well, one day I was visiting the site and an ad popped up looking for research participants for this schizophrenia research study! Here is the link: http://www.schizophreniaresearch.net/Involved.asp

Unfortunately, at this time it isn’t an Continue Reading Schizophrenia Research I’m Participating In…

Kevin’s Panic Attack Video

September 23, 2007 at 8:56 pm | Posted in Anti-anxiety meds, Anxiety, Anxiety Attacks, Ativan, Buspar, CapnOAwesome, Depression, Health, Kevin, Kristin Bell, Mental Health, Mental Illness, Panic Attacks, Problems, Psych Meds, Psychiatrist, Psychiatry, Relaxation, Therapist, Video, Xanex, YouTube | 10 Comments

Hi! Since a lot of my posts are about mental health issues, I thought I’d post this video that Kevin put up where he has an actual panic attack on video. Be warned, because it might disturb you. It is sad to watch him go through this. Kevin has two channels on Continue Reading Kevin’s Panic Attack Video…

Tips And Tricks For Surviving A Mental Illness #9

September 5, 2007 at 1:20 am | Posted in Acceptance, Anti-depressants, Anti-psychotics, Bipolar, Books, Depression, Eating Disorders, Education, Haldol, Health, Kristin Bell, Lithium, Lunatic, MAO Inhibitors, Medicine, Mental Health, Mental Illness, Mood Stabilizers, Prescription Meds, Problems, Psych Meds, Psychiatrist, Psychiatry, Psycho, Psychosis, Reading, Schizophrenia, Scientology, Surviving, Therapist, Tips & Tricks, Zoloft, Zyprexa | 1 Comment

neuron

Well, I think I have covered most of the basics regarding mental illness, or at least the ideas I had right off the top of my head. But, I haven’t covered this next topic yet, so here we go with number nine: Continue Reading Tips And Tricks For Surviving A Mental Illness #9…

Steps To Body Acceptance #3

August 12, 2007 at 2:35 am | Posted in Anorexia, Anti-depressants, Binge Eating, Body, Body Image, Boys/Men, Bulimia, Compulsive Eating, Compulsive Exercising, Counselor, Depression, Eating Disorders, EDNOS, Fat, Fat Acceptance, Fat Hatred, Figure, Grrls/Women, Health, Hiding, Kristin Bell, Measurements, Medicine, Mental Health, Mental Illness, Mirror, Obsessions, Problems, Psych Meds, Psychiatrist, Psychiatry, Psycho, Scales, Secrecy, Self, Shame, Social Worker, Steps To Body Acceptance, Surviving, Therapist, Thin, Uncategorized, Weight, Weightloss, Weightloss Industry | 9 Comments

shamegirl

For people who don’t have eating issues (hello? are there really any people out there without eating issues?) anyway, as I was saying for people without eating issues all of this body acceptance stuff must sound completely bizarre! I agree. We shouldn’t be so messed up about our bodies, but we are. So, on with step number three. For step number three Continue Reading Steps To Body Acceptance #3…

Steps To Body Acceptance #2

August 3, 2007 at 11:08 pm | Posted in Anorexia, Binge Eating, Body Image, Boys/Men, Bulimia, Compulsive Eating, Compulsive Exercising, Counselor, Eating Disorders, EDNOS, Fat, Fat Acceptance, Grrls/Women, Hate, Health, Hiding, Kristin Bell, Life, Measurements, Mental Health, Mental Illness, Obsessions, Problems, Secrecy, Self, Shame, Social Worker, Steps To Body Acceptance, Surviving, Therapist, Thin, Weight, Weightloss, Weightloss Industry | 2 Comments

tennis player

Okay, I do have to warn you that this advice is not for the weak of heart. I’m not an anorexic nutritionist giving you advice about how you can lose weight and then love yourself. I have my own baggage and my own prejudices. Continue Reading Steps To Body Acceptance #2…

Tips And Tricks For Surviving A Mental Illness #5

August 1, 2007 at 10:44 pm | Posted in AA, Acid, Alcohol, Alcoholics, Amblify, Anonymous, Anti-depressants, Anti-psychotics, Bipolar, Bong, Booze, Buspar, Cocaine, Coke, Counselor, Depakote, Depression, Downers, drugs, Ecstacy, Family, Friends, Geodon, Haldol, Haldol DEC, Haldol Decanoate, Health, Heroin, Kristin Bell, Life, Lithium, LSD, MAO Inhibitors, Marijuana, Mary Jane, Mental Health, Mental Illness, Mood Stabilizers, NA, Narcotics, Navane, Paxil, Pot, Prescription Meds, Problems, Prozac, Psych Meds, Psychiatrist, Psychiatry, Psycho, Psychosis, Risperdal, Schizophrenia, Seroquel, Smack, Social Worker, Teetotaller, Therapist, Tips & Tricks, Trazadone, Trilifon, Uppers, Weed, Wellbutrin, Zoloft, Zyprexa | 2 Comments

brainscan

Okay, I know I’m in trouble with this tip. I know there are some of you out there who are NOT going to like this one at all! Still I have to say it, because it is an issue. Continue Reading Tips And Tricks For Surviving A Mental Illness #5…

Tips And Tricks For Surviving A Mental Illness #4

July 31, 2007 at 2:43 am | Posted in Allies, Amblify, Anti-depressants, Anti-psychotics, Bipolar, Buspar, Counselor, Depakote, Depression, Discrimination, Effexor, Family, Friends, Geodon, Haldol, Haldol DEC, Haldol Decanoate, Kristin Bell, Lithium, MAO Inhibitors, Medicine, Mental Health, Mental Illness, Mood Stabilizers, Navane, Paxil, People, Problems, Prozac, Psych Meds, Psychiatrist, Psychiatry, Psycho, Psychosis, Risperdal, Schizophrenia, Seroquel, Shame, Social Worker, Support System, Surviving, Therapist, Tips & Tricks, Trazadone, Trilifon, Wellbutrin, Zoloft, Zyprexa | Leave a comment

braindiagram

I guess I sort of tipped you off to what I was going to be talking about in tip number three. Well, this next tip cannot be underestimated. It is really important no matter who you are, but for people with mental illness it is extremely important. Continue Reading Tips And Tricks For Surviving A Mental Illness #4…

Create a free website or blog at WordPress.com. | The Pool Theme.
Entries and comments feeds.

Follow

Get every new post delivered to your Inbox.

Join 87 other followers

%d bloggers like this: