The Relevance of Negative Symptoms in Schizophrenia and How to Treat Them with Psychopharmaceuticals?

Negative symptoms are highly prevalent in the acute episode and long-term course of schizophrenia. They are often persistent and tend to chronicity. They have an important negative impact on different dimensions of outcome and therefore require careful diagnosis and treatment. However, the evidence for the available psychopharmacological treatments is still not satisfactory and further research is needed. Antipsychotics, especially some second-generation antipsychotics, are the primary treatment of choice, particularly for negative symptoms in the acute episode. In case of residual negative symptoms concomitant treatment with antidepressants is often indicated. Glutamatergic compounds are of great theoretical interest as an add-on treatment or even as a monotherapy, but so far the efficacy results are inconsistent and their clinical use is limited.