Journal
BRITISH JOURNAL OF PSYCHIATRY
Volume 223, Issue 1, Pages 295-297Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1192/bjp.2022.191
Keywords
negative symptoms; psychopharmacology; antipsychotic; motivation; apathy
Categories
Ask authors/readers for more resources
Negative symptoms of schizophrenia, such as reduced motivation and impaired emotional expressivity, can be influenced by antipsychotic-induced sedation. This study found that sedation adversely affected motivation but not emotional expressivity in clozapine-treated patients. Clozapine also indirectly impaired motivation through worsening sedation, but after considering sedation, it improved motivation. These findings emphasize the importance of addressing sedative side-effects of antipsychotics for better clinical outcomes.
Negative symptoms of schizophrenia manifest as reduced motivation and pleasure (MAP) and impaired emotional expressivity (EXP). These can occur as primary phenomena, but have also been suggested to occur secondary to other clinical factors, including antipsychotic-induced sedation. However, this relationship has not been established formally. Here, we examined the effect of antipsychotic-induced sedation (assessed via the proxy of total daily sleep duration) on MAP and EXP in a cohort of 187 clozapine-treated patients with schizophrenia followed for over 2 years on average, using multilevel regression and mediation models. MAP, but not EXP, was adversely influenced by sedation, independently of the severity of psychosis or depression. Moreover, clozapine impaired MAP indirectly by worsening sedation, but after accounting for clozapine-induced sedation, clozapine improved MAP. Our results highlight the importance of addressing sedative side-effects of antipsychotics to improve clinical outcomes.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available