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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by ed_uk on March 25, 2005, at 14:07:49
Hello,
'Negative symptoms' are traditionally associated with schizophrenia but similar symptoms may also occur in people who are not psychotic, especially in depression. (or me on an SSRI)
The 'negative symptoms' of schizophrenia include.... (from schizophrenia.com)
1. Lack of emotion - the inability to enjoy activities as much as before.
2. Low energy - the person sits around and sleeps much more than normal.
3. Lack of interest in life, low motivation.
4. Affective flattening - a blank, blunted facial experession or less lively facial movements or physical movements. Absence of emotion.
5. Alogia (difficulty or inability to speak).
6. Inappropriate social skills or lack of interest or ability to socialize with other people.7. Inability to make friends or keep friends, or not caring to have friends.
8. Social isolation - person spends most of the day alone or only with close family.
In patients with schizophrenia, negative symptoms may improve with atypical antipsychotics, especially clozapine (Clozaril).Has anyone on p-babble ever used clozapine to treat 'negative symptoms' which occured as a feature of depression (including bipolar depression)?
Ed.
Posted by ed_uk on March 25, 2005, at 18:46:48
In reply to 'Negative Symptoms': Clozapine (Clozaril/Leponex), posted by ed_uk on March 25, 2005, at 14:07:49
Posted by Phillipa on March 25, 2005, at 18:52:06
In reply to 'Negative Symptoms': Clozapine (Clozaril/Leponex), posted by ed_uk on March 25, 2005, at 14:07:49
Are you looking into it for J. Fondly, Phillipa O
Posted by med_empowered on March 25, 2005, at 21:32:51
In reply to Re: 'Negative Symptoms': Clozapine (Clozaril/Leponex) » ed_uk, posted by Phillipa on March 25, 2005, at 18:52:06
hey! There's a difference, apparently, between the "negative symptoms" of chronic psychotic disorders (schizoaffective disorder, schizophrenia) and "depression." That said, it seems that some docs are trying anti-depressants, especially the SSRIs and "novelty" ADs, to help out with the "negative symptoms" of schizophrenia AND to treat the depressive episodes many schizophrenics experience. (The Tricyclic anti-depressants apparently increase the risk of psychosis, and some experts think they increase the risk of tardive dyskinesia...I imagine the MAOIs are rarely used for obvious reasons).
Posted by ed_uk on March 26, 2005, at 9:19:04
In reply to Re: 'Negative Symptoms': Clozapine (Clozaril/Leponex) » ed_uk, posted by Phillipa on March 25, 2005, at 18:52:06
Hi P!
No, I'm just interested.
Ed xxx
Posted by ed_uk on March 26, 2005, at 9:29:49
In reply to Re: 'Negative Symptoms': Clozapine (Clozaril/Leponex), posted by med_empowered on March 25, 2005, at 21:32:51
Hi Med,
>There's a difference, apparently, between the "negative symptoms" of chronic psychotic disorders (schizoaffective disorder, schizophrenia) and "depression."
I know but I was still interested in whether anyone had tried clozapine to treat TR-depression with prominent 'negative symptoms'.
Since there are quite a few depressed people on this board (not me) who have tried virtually every psych drug in existence, I wondered whether clozapine might be helpful!
I've known a few people who've taken clozapine for indications other than schizophrenia, mainly bipolar disoder. I once met someone who was on a trial of clozapine for borderline personality disorder.
Ed.
Posted by ed_uk on March 26, 2005, at 9:47:00
In reply to Re: 'Negative Symptoms': Clozapine (Clozaril/Leponex) » med_empowered, posted by ed_uk on March 26, 2005, at 9:29:49
I did find a couple of reports.......
In agitated depression........
Clin Neuropharmacol. 1998 Mar-Apr;21(2):132-4.
Clozapine for the treatment of agitated-depressed patients with cognitive impairment: a report of three cases.
Nacasch N, Dolberg OT, Hirschmann S, Dannon P, Grunhaus LJ.
Department of Psychiatry C, Sheba Medical Center, Ramat-Gan, Israel.
.................................In this report we present the cases of three patients hospitalized at the psychiatric division of the Sheba Medical Center, diagnosed with major depressive disorder with cognitive impairment, whose presenting symptom was agitation. These patients were nonresponders to various treatment modalities. However, treatment with clozapine brought about a favorable response.
In psychotic depression..........Biol Psychiatry. 1996 Aug 15;40(4):253-8.
Acute and long-term effectiveness of clozapine in treatment-resistant psychotic depression.Ranjan R, Meltzer HY.
Department of Psychiatry, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.
The treatment of refractory major depression, including the psychotic subtype, is a therapeutic challenge. Three cases of resistant psychotic depression were treated with clozapine monotherapy, an atypical antipsychotic drug effective in treatment-resistant schizophrenia and mania. Both psychotic and mood symptoms responded well to clozapine monotherapy, although response was delayed in one case. Tardive dyskinesia improved markedly, and tardive dystonia improved moderately in one patient. No patient relapsed during a follow-up period of 4-6 years of clozapine treatment. Clozapine was well-tolerated with few side effects. These observations suggest controlled trials of clozapine in the treatment of psychotic depression that fails to respond to electroconvulsive therapy or typical neuroleptics plus tricyclic antidepressants are indicated. The same is true for the use of clozapine in maintenance treatment for psychotic depression in those cases in which typical neuroleptic drugs are required, in order to reduce the risk of tardive dyskinesia and dystonia.
This is the end of the thread.
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