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Treating Negative Symptoms and Cognitive Deficits in Schizophrenia

The following treatment guidelines are meant as a reference tool only, and are not intended as treatment advice or to replace the clinical decision-making process of psychiatrists or other health professionals who administer these treatments. In clinical practice there are often good reasons why treatment approaches differ from what is described here.


Negative symptoms of Schizophrenia are among the most difficult features of the condition to treat. Studies looking at the effects of various kinds of medications for treating these symptoms have shown varying results, and no treatment stands out as being particularly effective [ref].

Amisulpride when used in low doses, and Aripiprazole, have gained a reputation as being particularly effective in alleviating negative symptoms because in several studies they have been shown to be measurably better than placebo pills for this purpose [ref, ref]. However, there is still little evidence that these medications are much better than other antipsychotics in this regard [ref, ref, ref].

SSRI antidepressants, and NMDA agonists, show some promise for treating negative symptoms, but further studies are required before firm conclusions can be drawn [ref].

Taking supplements of Folate (2mg daily) and Vitamin B12 (400 μg daily) has been shown in one large study to improve negative symptoms, but only in individuals with a particular genetic variation of folate absorption [ref].

When it comes to treating the cognitive deficits that can occur in Schizophrenia (which are probably not much different than the negative symptoms [ref]), it seems that antipsychotics can offer a modest amount of benefit when used early in the course of the illness, and these effects seem to be separate from their ability to treat the actual psychotic symptoms [ref]. Typical and Atypical Antipsychotics appear to be equally effective at treating these cognitive deficits [ref].


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