Negative symptoms in schizophrenia: An open study placebo-fluvoxamine treatment added to neuroleptics

Neuroleptic treatment often produces an improvement of positive symptoms in schizophrenic patients but negative ones are hardly affected. Since 1954, many studies suggest an involvement of serotoninergic system in schizophrenia, either as a deficiency or an increase of Central Nervous System serotonin (CNS 5-HT). From a clinical point of view 5-HT dysfunction was related to certain features of Crow's type II schizophrenia, such as 'negative' symptoms. Studies involving drugs which affect 5-HT system were performed with agonists and antagonists of CNS 5-HT receptors, but the results were contradictory. The authors treated twenty-three schizophrenic patients, with prevalent negative symptoms with placebo added to their previous neuroleptic therapy (four weeks) and then with a daily dose of 100 mg. of fluvoxamine, a selective serotonin reuptake inhibitor (SSRI). Negative symptomatology significantly improved in sixteen patients while the positive ones remained unchanged.