Posted by JohnL on December 1, 2000, at 5:25:22
In reply to negative symptoms, posted by Maniz on November 30, 2000, at 17:36:35
> Hi,
>
> I have read in this forum references to "negative symptoms". Are these only for psychosis or also for inhibition, procrastination, social phobias, etc?.
>
> Which medication can help?.
>
> ThanksHi Maniz. How's it going?
Negative symptoms are used to describe certain parts of schizophrenia, such as anhedonia (lack of pleasure in ordinary hobbies and activities), social withdrawal, apathy, emotional numbness. I think though that there is considerable overlap between this form of schizophrenia, depression, dysthymia, bipolar, social anxiety, etc. Though doctors attempt to draw clear boundaries between these different diagnosis, I don't see that that can realistically be done. There is just too much overlap. Too many gray areas. It's seldom black and white. In his book "Dysthymia, the Spectrum of Chronic Depression" the world renowned psychiatrist Hagop Akiskal pretty much says the same thing.
In my worst moments I clearly qualify for a diagnosis of major depression. When I've recovered somewhat, I more clearly qualify for dysthymia. But on the other hand, negative symptoms of schizophrenia actually describe my symptoms even more accurately than dysthymia. Which diagnosis is correct? Who knows. Who cares. I think what's important is that there is some chemical imbalance or malfunction underlying the whole mess, and finding a drug(s) that corrects those problems is all that matters. Putting a name on it just seems too inaccurate. It does though help to decide what class of drugs might work better than another. Any class of drugs could work, but the odds may be better with one than another, and that would be the place to start.
I think negative symptoms can easily be confused with certain kinds of depression. I'm not so sure there's any difference actually. For these kinds of symptoms though, whatever someone wants to name them, I think noradrenaline and dopamine drugs have better odds of working than serotonin drugs. Generally speaking, this is how different neurotransmitters are hypothesized to affect mood:
Serotonin-Overall wellbeing and calmness.
Norepinephrine-Drive, energy, and motivation.
Dopamine-Pleasure.Serotonin drugs for me work in a sense that they can make me undepressed. Yet even though I'm undepressed, I have no drive, no motivation, and no interest or pleasure in anything. Adrafinil which works on noradrenaline, and Amisulpride which works on dopamine, wipe out these symptoms almost completely. Other drugs that may be effective for so-called negative symptoms would include: Ritalin or Adderall; Effexor; Zyprexa or Risperdal; Nortriptyline or Desipramine; Lithium.
In a nutshell I think that one's symptoms can help to determine which class of drugs might be more helpful, but giving that set of symptoms a name is not all that clinically useful. There is just so much overlap and too many gray areas. That's how I see it anyway.
John
poster:JohnL
thread:49706
URL: http://www.dr-bob.org/babble/20001130/msgs/49744.html