In discussion with the ECNP Neuropsychopharmacology Award Winner: negative symptoms in schizophrenia - from biology to clinical practice

This session will consider the mechanisms that underlie both primary and secondary negative symptoms, focusing on new findings from the Howes’ group showing for the first time that a D2 partial agonist does not induce negative symptoms, in contrast to a D2 antagonist. Moreover, this study showed that the induction of negative symptoms by the D2 antagonist was related to the blunting of the caudate response to reward. These findings indicate that treatment with D2 antagonists could induce secondary negative symptoms but this is less likely with a D2 partial agonist, suggesting the latter should be used in preference. The mechanism underlying primary negative symptoms was investigated using a PET technique that measures brain serotonin release, showing that patients with negative symptoms show elevated cortical serotonin release. This suggests that targeting the serotonin system may be a novel treatment target for primary negative symptoms. These findings and their treatment implications will be discussed.