Drug to treat flat affect in schizophrenia shows promise

That is the title of this article I am writing about.  "AMSTERDAM – Patients with schizophrenia given the investigational drug cariprazine showed statistical improvements in negative symptoms such as apathy and withdrawal, compared with those given risperidone, results from a phase III clinical trial have shown. The data were presented at the annual congress of the European College of Neuropsychopharmacology.  Both drugs are antipsychotics, but risperidone is a dopaminergic antagonist, and cariprazine is a D2 and D3 receptor partial agonist, tending toward the D3 receptor. Currently, no drugs are on the market with a specific indication for treating the negative symptoms of schizophrenia, although several second-generation antipsychotics reduce negative symptoms as well as positive and general symptoms of schizophrenia. Several pharmacotherapies are available to treat the positive symptoms of the illness.  In this multicenter, international, double-blind study, 230 adults with schizophrenia were randomly assigned to receive cariprazine and 231 were assigned risperidone for 26 weeks, reported Dr. György Németh, one of the study’s lead authors and chief medical officer of the study’s sponsor, Gedeon Richter." I do know from what I read that this drug is welcome by both people with schizophrenia and bipolar disorder.  They say no drug on the market treats both.
The article goes on to say: "People included in the study had been stable for at least 6 months prior to screening, and for a subsequent 4 weeks prior to randomization. Those with a score of at least 24 or greater on the Negative Factor Scale of the Positive and Negative Syndrome Scale (PANSS-NFS) and a score of at least 4 on two of the three core negative symptoms, along with positive factor scores on the PANSS of at least 19 or more were considered for inclusion in the study. At baseline, both groups had similar PANSS scores: Negative factor scores in the study drug arm were 27.7 and 27.5 in controls. Positive factor scores were also similar: 8.8 in the study arm and 8.6 in controls.

Study participants also were measured at baseline on the Personal and Social Performance Scale. Scores were 48.8 in the study drug arm and 48.1 in the risperidone arm.  After a 2-week period of cross-titration and washout of previous medications, patients were treated with the target dose of 4.5 mg daily of their assigned drug for 24 weeks." This is from the makers of Geodon that is what I take now and for me it has been a wonder drug.  I have no symptoms either positive or negative. If this helps people able to not withdrawal from society it would be great.

The article ends: "In the 77.4% of enrollees in both cohorts who completed the trial, those treated with cariprazine had the most improvement in both negative symptoms and personal and social performance, compared with the control group. At 26 weeks, the overall change from baseline in the study group for negative factor symptoms was –2.39, compared with –0.53 in controls (95% confidence interval; P = .002). Personal and social performance scores changed at 26 weeks from baseline by 2.71 in the study group and 6.56 in controls (95% CI; P less than .001).

Discontinuation rates were low, and the most common side effects were insomnia and headache (about 10% for each), mostly in the risperidone arm.  Dr. David Pickar, who was not involved in the study, said in an interview that when treating patients with schizophrenia “improvement in negative symptoms occurs a fair amount with improvements in positive symptoms. The problem is the persistence of negative symptoms,” said Dr. Pickar of the department of psychiatry at Johns Hopkins University, Baltimore, and former branch chief of intramural experimental therapeutics at the National Institute of Mental Health.  This trial was sponsored by Gedeon Richter."They do need a drug that gets rid of all negative symptoms. I personally would like to read that all people with schizophrenia are doing well working if they would like and be able to not suffer with negative symptoms.

Apathy: An Unseen Connection

There is a strong connection which bonds apathy and other mental illnesses.  For instance apathy is a symptom of schizophrenia and the many people who have a schizophrenic diagnosis show little interest in people, events or emotions.  In other words they have “tuned out” a portion, if not all of reality.  People who are suffering from depression are often negative in their feelings of what surrounds them; as such they too have no interest in anything which gives pleasure or any experience which can bring them joy.

What is apathy?  Apathy in short is indifference, a lack of will or motivation to care.  Apathy is not depression it is a symptom, the result of an illness, event, though it is an illness, you can even relate it to being a symptom to other more physical diseases such as Alzheimer disease.  It is said that people who are apathetic do not take care of themselves as well as other consumers who are not apathetic, but this is said only in relation to other psychiatric illnesses.

 “The world Health Organization defines health as an optimal state of being that maximizes ones potential, for physical, mental, emotional and spiritual growth.”

Apathy -effects, withdrawal, people, effect, health, mood, Definition, Description

I have sat for many hours with my mind closed to the outside world in the past, not only ignoring social activities, yet also closed to the emotions of myself and finding only darkness inside and people to eschew from my way of life.  I had no idea I was apathetic, living without motivation, lacking any pleasurable existence, because I did not want to find one.  I understood the physical aspect of my life was suffering in a small sense, yet it is not depression I am suffering from, though during these times I did not understand what it meant to be Bi-Polar either, I was living in an up and down kind of world.  Many, many people experience apathy at one time or another, the reality of its disappointment is an uncaring attitude or slothful emotion, which is a part of life and apathy is a way to hide, with these negative symptoms such as stress can be dealing with external problems.  Yet, apathy can “enable people to move forward” and try something new when the rope loosens: you can see what is new which has become a part of the smile you’ve lost. 

Written by Donald S.