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 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
• NAMI Peer-to-Peer
– Free, 9-week educational course on recovery
• NAMI Connection
– Recovery support group for adults
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.
Share this:
- Click to print (Opens in new window)
- Click to email this to a friend (Opens in new window)
- Click to share on Facebook (Opens in new window)
- Click to share on Pocket (Opens in new window)
- Click to share on LinkedIn (Opens in new window)
- Click to share on Reddit (Opens in new window)
- Click to share on Pinterest (Opens in new window)
- Click to share on Tumblr (Opens in new window)
- Click to share on Twitter (Opens in new window)
Contact Me!
kristin@kristinbell.org
Kristin Bell
PO Box 822735
Vancouver, WA 98682
USA
Blogroll
-
Recent Posts
Archives
- January 2019 (1)
- August 2018 (1)
- July 2018 (3)
- March 2018 (1)
- January 2018 (3)
- June 2017 (2)
- April 2017 (1)
- January 2017 (1)
- December 2016 (2)
- September 2016 (6)
- May 2016 (1)
- March 2016 (1)
- February 2016 (1)
- December 2015 (4)
- November 2015 (4)
- October 2015 (5)
- August 2015 (3)
- December 2014 (2)
- October 2014 (2)
- September 2014 (1)
- April 2014 (3)
- December 2013 (6)
- November 2013 (5)
- October 2013 (6)
- August 2013 (1)
- July 2013 (3)
- June 2013 (5)
- May 2013 (3)
- March 2013 (2)
- February 2013 (4)
- January 2013 (4)
- December 2012 (11)
- November 2012 (7)
- October 2012 (5)
- September 2012 (8)
- August 2012 (16)
- July 2012 (2)
- June 2012 (7)
- May 2012 (19)
- April 2012 (13)
- March 2012 (14)
- February 2012 (6)
- January 2012 (5)
- December 2011 (4)
- September 2011 (6)
- August 2011 (5)
- June 2011 (1)
- May 2011 (2)
- March 2011 (6)
- February 2011 (7)
- January 2011 (8)
- December 2010 (2)
- November 2010 (3)
- October 2010 (2)
- September 2010 (11)
- August 2010 (2)
- July 2010 (1)
- May 2010 (1)
- January 2010 (1)
- December 2009 (2)
- November 2009 (9)
- September 2009 (1)
- June 2009 (1)
- May 2009 (2)
- April 2009 (1)
- March 2009 (1)
- January 2009 (4)
- December 2008 (8)
- November 2008 (5)
- October 2008 (2)
- August 2008 (2)
- July 2008 (1)
- June 2008 (1)
- May 2008 (2)
- April 2008 (3)
- March 2008 (4)
- February 2008 (6)
- January 2008 (2)
- December 2007 (7)
- November 2007 (7)
- October 2007 (9)
- September 2007 (17)
- August 2007 (35)
- July 2007 (27)
Nerdiness Rocks!
Blog Stats
- 196,133 hits
Meta
Create a free website or blog at WordPress.com.
Entries and comments feeds.