Blog · Evidence, in plain language

Negative symptoms of schizophrenia: what we tell patients.

Patients ask us about a news item from this month: an app cleared by the FDA for the negative symptoms of schizophrenia, the low motivation and withdrawal that medicines treat least well. The trial behind it is solid and its result is modest, and both halves of that sentence matter. This is the summary we give, with links to the fuller posts on our clinical sites.

By Karel Winner, DNP, PMHNP-BC · Published October 27, 2026

This post is education from the practice, not medical advice. It summarizes a published trial and a regulator decision. It is not a recommendation about any individual's care, and this practice does not prescribe the product discussed.

The short answer

Negative symptoms are the subtractive side of schizophrenia: reduced motivation, reduced pleasure, and social withdrawal. No FDA-approved medicine is specifically indicated for them. In a phase 3 trial called CONVOKE, 457 adults who were stable on antipsychotic medication were randomized to a prescription smartphone program, CT-155, or to a control app, for 16 weeks. Motivation and pleasure symptoms improved more with the therapeutic program, by 6.8 points against 4.2 points on the trial's main scale, a statistically significant difference the authors call small to moderate. In October 2026 the FDA cleared the product, under the name Motivista, as an adjunct to clinician-managed outpatient care for adults with clinically stable positive symptoms. It is an addition to medication care, not a substitute for it.

What we are careful about

Both groups improved, so part of what the trial measured is the effect of structure, contact, and expectation, which the control app also provided. The gains sat mainly in social and recreational functioning; work and school functioning barely differed, expressive symptoms did not significantly improve, and patients' own overall ratings were no longer significantly different by week 16. The trial required stable medication, a smartphone, and regular internet access, and it excluded people receiving psychotherapy, so it says nothing about how the program compares with a therapist. It was funded by Boehringer Ingelheim and codeveloped by the companies selling it, with company employees among the authors. We regard it as a real, bounded result that independent studies should now test.

How it fits care here

Our practice treats schizophrenia with medication management, and with therapy where it belongs in the plan. The part of this news that fits our experience is the target, not the device: when positive symptoms settle, the remaining disability is usually the negative symptoms, and they deserve to be named, measured, and planned for rather than treated as the patient's effort problem. Whether a prescription app is the right vehicle for a given patient is a visit decision, made against their stability, their current medicines, and their access to in-person psychosocial care. We do not prescribe this product, and we make no claim about it beyond what the trial and the clearance state.

Read more, by door

Each clinical site in this practice keeps its own blog, and each has written this topic for its own readers. For the combined therapy and medication perspective, psych.us has published negative symptoms of schizophrenia, explained, covering what these symptoms are and how the trial was run. For the medication focused read, PsychMed Care has published negative symptoms and a new app, including how to read the headline percentage and what this means at a medication visit. When reading has done all it can, the booking page is the next step.

Sources

The summary above rests on the sources below.

Pratap and colleagues, JAMA Network Open (2026): the CONVOKE trial, a phase 3, double-blind, randomized trial of the smartphone therapeutic CT-155 against a digital control app in 457 adults with negative symptoms of schizophrenia, run at 66 sites in the United States. JAMA Network Open.

ClinicalTrials.gov record NCT05838625: the registered CONVOKE study, its design, its eligibility rules, and its primary outcome measure. ClinicalTrials.gov record.

Click Therapeutics announcement, October 5, 2026: the FDA granted 510(k) clearance to Motivista (CT-155) for the treatment of negative symptoms of schizophrenia, as an adjunct to clinician-managed outpatient care including antipsychotic therapy, in patients 18 years of age and older with clinically stable positive symptoms. FDA clearance announcement.

Please read this part

This post is educational and does not create a treatment relationship. A published trial describes group averages in a selected population and cannot predict how any one person will respond to a treatment. Patients of this practice who live with negative symptoms should raise them at a visit, where their own history and medication list can be weighed. Nothing here is a reason to change a working treatment on your own, and this post gives no dosing information.

If you are having thoughts of harming yourself, help is available now: call or text 988, text HOME to 741741 for Crisis Text Line, or call the NAMI Helpline at 1-800-950-6264. This practice is not an emergency service. If someone is in immediate danger, call 911. The crisis page lists more options.