Negative symptoms of schizophrenia: An update

T he negative symptoms of schizophrenia have been recog- nized for 100 years.Characterized by a loss of a function that should be present, negative symptoms include anhedonia, asociality, amotivation, and affective blunting.Individuals with schizophrenia who have a preponderance of negative symptoms ("deficit syndrome") may comprise a special subset of patients.Compared with positive symptoms, negative symptoms are associated with worse global functioning and worse response to antipsychotic medication.Treatment of negative symptoms is challenging.Secondary negative symptoms-those that simulate or resemble primary negative symptoms but are attributable to another cause, such as major depressive disorder or the adverse effects of antipsychotic medication-need to be ruled out.Emerging evidence suggests that newer antipsychotics with novel mechanisms might be effective in treating negative symptoms.Antidepressants might also play a role.This article describes types of negative symptoms, their clinical relevance, neuroanatomical and neurotransmission factors associated with negative symptoms, and current and future treatment options. Modest improvements with antipsychoticsSchizophrenia affects an estimated 1% of the population. 1 Antipsychotic medication has been the mainstay of schizophrenia treatment since chlorpromazine was introduced in the 1950s; it was soon followed by many other antipsychotics.These first-generation antipsychotics (FGAs) were joined by second-generation antipsychotics (SGAs) in the 1990s.While SGAs are better tolerated and less likely to induce extrapyramidal of schizophrenia: AN UPDATE