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.

Negative Symptoms of Schizophrenia Linked to Worse Outcome

That is the title of this article I am writing about. "Negative symptoms in patients with schizophrenia are associated with an increased likelihood of hospital admission, longer duration of admission, and an increased likelihood of re-admission following discharge, according to a new study by researchers at King’s College London. Negative symptoms include poor motivation, poor eye contact, and a reduction in speech and activity. As a result, people with schizophrenia often appear emotionless, flat, and apathetic. These contrast with the positive symptoms of hallucinations or delusions, which are typically the first targets of treatment.  The study is the largest ever to investigate a relationship between negative symptoms and clinical outcomes, pulling from a sample of more than 7,500 patients."The people with negative symptoms can tell you all this because they suffer everyday with negative symptoms.
The article goes on to say: "'Hospital admissions are the main drivers of cost in the care of patients with schizophrenia — yet they have traditionally been linked to the severity of positive psychotic symptoms,' said Dr. Rashmi Patel from the Department of Psychosis Studies. Our data indicate that negative symptoms are an equally important factor, and suggest that a greater emphasis on assessing and treating these features of schizophrenia may have significant health economic benefits.”
'However, as our findings are drawn from observational data, interventional clinical studies are required to determine whether an effective treatment for negative symptoms would lead to better clinical outcomes.'  For the study, researchers used the Clinical Record Interactive Search (CRIS) application, a text-mining tool, to analyze anonymous patient data on negative symptoms. Natural Language Processing (NLP) was used to detect statements within the clinical records that determined references to specified negative symptoms."I think if you would get rid of the negative symptoms you would find more people with schizophrenia working. I know they are just observing but I read about it everyday.
The article ends with: "Ten negative symptoms were identified, including poor motivation, blunted or flattened mood, poor eye contact, emotional withdrawal, poor rapport, social withdrawal, poverty of speech (excessively short speech with minimal elaborations), inability to speak, apathy, and concrete thinking (the inability to think in abstract terms).  The researchers found that 41 percent of patients exhibited two or more negative symptoms. Negative symptoms across the sample were associated with an increased likelihood of hospital admission, longer duration of admission, and an increased likelihood of re-admission following discharge from hospital.  In fact, patients with two or more negative symptoms were 24 percent more likely to have been admitted to the hospital. In addition, each of their admissions were, on average, an extra 21 days in duration and, when discharged, these individuals had a 58 percent higher risk of re-admission within 12 months.  The most frequently recorded negative symptoms were poor motivation (31 percent), blunted or flattened mood (27 percent), poor eye contact (26 percent), and emotional withdrawal (24 percent). If a person had all those negative symptoms you would think something would have been done by now.  Especially the poor motivation.  It is hard to get anything done when you are fighting just to do it. Everyone needs motivation  and not a flatten mood.

Many With Schizophrenia Say They’re Happy: Study

That is the title of this article about people with schizophrenia saying they are happy.  The article sounds good since many with schizophrenia have negative symptoms. “Even though schizophrenia is one of the most severe forms of mental illness, nearly 40 percent of people with the disorder say they’re happy, new research contends.  Researchers at the University of California, San Diego, surveyed 72 schizophrenia patients, ranging in age from 23 to 70, living in the San Diego area, and found that 37 percent said they were happy all or most of the time.  Their happiness wasn’t related to the length or severity of their mental illness, to their mental or physical status, or to factors such as age and education.  Instead their happiness was associated with positive mental and social characteristics such as optimism, resilience and lower stress levels, the researchers said.” I would guess they are not the ones that have problems due to negative symptoms.  They are just ordinary folks that have a mental illness but do not let it define them.
The article goes on to say: “The findings are valuable because these positive traits can be taught to many people, said the authors of the study, which was published online Aug. 18 in the journal Schizophrenia Research. ‘People tend to think that happiness in schizophrenia is an oxymoron,’ senior author Dr. Dilip Jeste, a professor of psychiatry and neurosciences, said in a university new release. ‘Without discounting the suffering this disease inflicts on people, our study shows that happiness is an attainable goal for at least some schizophrenia patients.  This means we can help make these individuals’ lives happier,’ Jeste added.  By way of comparison, about 83 percent of people without schizophrenia said they were never or rarely happy, compared with about 15 percent of those with the mental disorder.” If they can help make people happier then I am all for it.  I am hardly down that much although I am not happy all the time there are things that come up that makes being happy all the time less likely to happen.
The article ends with: “People with schizophrenia are clearly less happy than those in the general population at large, but this is not surprising,’ study lead author Barton Palmer, a professor in the university’s department of psychiatry, said in the news release.  ‘What is impressive is that almost 40 percent of these patients are reporting happiness and that their happiness is associated with positive psychosocial attributes that can be potentially enhanced,’ Palmer added.  The study was funded, in part, by the U.S. National Institute of Mental Health (NIMH) According to the NIMH, schizophrenia is a chronic, severe and disabling brain disorder.  People with the disorder may hear voices other people don’t hear, they may believe other people are reading their minds, controlling their thoughts or plotting to harm them.  This can make them withdrawn or extremely agitated.”  That in itself can make a person not to happy all the time to be controlled by symptoms.  Problems come and go to always be happy is a very good thing. I am usually happy until a problem outside my control happens.  It is a good study and happy they did it.

Stigma and Self Stigma

It still is out there stigma.  This article talks about being resilient and I believe all people with a mental illness are resilient.  Just look what we came through a mental illness.  I know for a fact that it was the worst thing I had ever been through.  Why are there so many stigmas then?  How can a person go from being sane one day and then wake up and they have a mental illness?  I was in prison when my mental illness reared its ugly head.  That is the last place anyone would want to wake up a paranoid schizophrenic.  It is a shame that a person cannot be viewed for what they do in this world and not be defined as crazy because they have a mental illness.
I for one am highly functioning person with a mental illness.  I do not disclose I have a mental illness because an incident happened at my apartment building.  When my fridge was acting up it was hard enough getting them to replace it.  If they would have knew that I had a mental illness I would have been laughed at and never would have it replaced.  It is hard enough getting things done without a mental illness.  I remember when I first starting looking for apartments I told the landlady at one that I had a mental illness and she stopped talking to me and just talked to my sister who went with me.  I know I am not the only one.  I know for a fact there are a lot of people that are higher functioning that do not disclose that they have a mental illness not that they are ashamed but because the way people react to the news.
When they say diversity is that not all people no matter how they act or if they are different.  Why do ones quirks become different when that person has a mental illness?  Then they are just crazy if they do something different than the average person.  When they just grew up different than you or I in this world so of course they would be different.  Mental illness changes a person and they have to adjust to being different.  They are not only viewed different also they have changed inside or outside.  They may now have negative symptoms they have to deal with.  They now have to take medication every day.  Just to lead a fairly normal life then they have to put up with all the negative press and people.
I look forward to the day when there is no more stigma or self-stigma. Life is hard enough dealing with the fact that you just came through something that a normal person never has to go through.  If you can become a success that would be the best way to answer back I am ok. Life does go on and hopefully a person continues to grow even if they have a mental illness and just deal with life as it is.