title: Antipsychotics and amotivation.
abstract: Antipsychotic drugs are thought to produce secondary negative symptoms, which can also exacerbate primary negative symptoms. In the present study, we examined whether motivational deficits in particular were related to antipsychotic treatment in patients with schizophrenia in a dose-dependent manner. Five hundred and twenty individuals with schizophrenia who were receiving antipsychotic monotherapy for at least 6 months and followed prospectively were included in the present study. Participants were receiving one of five antipsychotic medications (olanzapine, perphenazine, quetiapine, risperidone, or ziprasidone), and analyses were conducted for patients receiving each drug separately. Analysis of covariance models were constructed to examine the effect of antipsychotic dose on level of motivational impairment, controlling for selected demographic and clinical variables (eg, positive symptoms). Level of motivation, or deficits therein, were evaluated using a derived measure from the Quality of Life Scale, and in addition with scores derived from the Positive and Negative Syndrome Scale. Antipsychotic dose was not related to the level of amotivation for any of the medications examined. Moreover, severity of sedation was not significantly related to the degree of amotivation. One hundred and twenty-one individuals were identified as antipsychotic-free at baseline, and after 6 months of antipsychotic treatment, no change in motivation was found. Chronic treatment with antipsychotics does not necessarily impede or enhance goal-directed motivation in patients with schizophrenia. It is possible that the negative impact of antipsychotics in this regard is overstated; conversely, the present results also indicate that we must look beyond antipsychotics in our efforts to improve motivation.
authors.affiliation: 1] Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada [2] Institute of Medical Science, University of Toronto, Toronto, Canada.
authors.forename: Gagan
authors.initials: G
authors.lastname: Fervaha
authors.affiliation: 1] Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada [2] Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Takeuchi
authors.affiliation: 1] Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada [2] Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Lee
authors.affiliation: 1] Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada [2] Institute of Medical Science, University of Toronto, Toronto, Canada [3] Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Foussias
authors.affiliation: 1] Department of Psychiatry, University of Toronto, Toronto, Canada [2] Biopsychology Section, Centre for Addiction and Mental Health, Toronto, Canada.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Fletcher
authors.affiliation: 1] Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada [2] Institute of Medical Science, University of Toronto, Toronto, Canada [3] Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Ofer
authors.initials: O
authors.lastname: Agid
authors.affiliation: 1] Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada [2] Institute of Medical Science, University of Toronto, Toronto, Canada [3] Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Gary
authors.initials: G
authors.lastname: Remington
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000187:drug effects*; D011581:Psychological Tests; D011788:Quality of Life; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D014481:United States; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives