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May 06, 2006
New solutions in Pharmacotherapy of Schizophrenia
by SirGan
 Schizophrenia is a chronic, severe, and disabling psychiatric disorder that affects about 1 percent of people all over the world. This brain disorder is characterized by:
This condition can cause a parson to withdraw from the people and activities in the world around it and to retreat into a world of delusions or separate reality. Contrary to the common misconception, schizophrenia does not mean split or multiple personality. Although, many experts claim that there is not much more to discover about this strange disorder- schizophrenia still remains one of the most disabling and puzzling mental disorders.
Incidence of schizophreniaThe illness affects approximately 1 percent of the population worldwide. In men, schizophrenia typically emerges in the teens or 20s. In women, the onset of schizophrenia typically is in the 20s or early 30s, but, it is found approximately equally in men and women. The illness represents a significant economic and social burden. It is one mental disorder that, in the US, has a lifetime prevalence of approximately 1%. It has been estimated that approximately 0.025% to 0.05% of the total population is treated for schizophrenia in any 1 year.
Possible causes of schizophreniaNo one really knows for sure what the precise cause of schizophrenia is, although experts have suggested several possible theories. The most common are:
Some researchers have proposed that environmental influences during childhood also interact with increased risk factors of developing schizophrenia later in life.
Part of these processes that happens during pregnancy is also extremely important! Some even believed that some infections in pregnancy can lead to child’s schizophrenia but there were now significant evidence that prenatal exposure to infections increases the risk for developing schizophrenia later in life.
The fact is that the neurological development of children is considered very sensitive on outer influences such as trauma, violence, lack of warmth in personal relationships and hostility. Symptoms of schizophreniaThere is number of possible symptoms that could be associated with the schizophrenia and the most common are:
In general, all symptoms of schizophrenia could be grouped into three categories: negative, positive and cognitive.
Negative signs and symptomsThese signs are called negative because something is missing from the person’s behavior. They may appear early in the disease, and a person may not think he or she needs treatment.
Such signs may include:
Positive signs and symptomsThese symptoms are called positive because they indicate that sometimes has been added to the person’s behavior! The characteristic positive signs are hallucinations and illusions!
Cognitive signs and symptomsThese signs and symptoms tend to be more subtle than positive and negative ones. Cognitive signs and symptoms may include:
Drug abuse and schizophreniaThe fact is that drug abuse is more common in people with schizophrenia. Nicotine is a commonly abused drug by people with schizophrenia; but also several other drugs such as amphetamines, cocaine and marijuana, commonly used by schizophrenics can make schizophrenia symptoms worse.
Schizophrenia and suicideDevastating facts are that one in ten persons suffering from schizophrenia commits suicide. Four in ten are known to have attempted suicide. Feelings of being alone, not having family or other support are considered main risk factors. It is proven that only 2% of those with schizophrenia who commit suicide did so in response to their voices. Young men and those with chronic illness are more at risk. A good educational background and high performance expectations are also risk factors.
Pharmacotherapy of SchizophreniaTreatment of schizophrenia includes medication and non-medication approach and both of them could be very effective if done correctly and in time.
Antipsychotic medications, also known as neuroleptics, are the cornerstone of treatment. The fact is that these last couple of years, antipsychotics were generally were much more effective in controlling positive symptoms than negative symptoms. But now, there are several new generations of antipsychotic medications which provide more effective management of both positive and negative symptoms. These antipsychotics include:
In general, the goal of treatment with antipsychotic medications is to effectively control signs and symptoms at the lowest possible dosage.
New solutions in pharmacotherapyThe fact is that science reveals more and more about the underlying pathophysiology of schizophrenia. The progression of anti-psychotic medications is definitely unstoppable.
Dopamine hypothesisThe dopamine hypothesis was the leading theory about the cause of schizophrenia. Therefore, treatment of choice was based on generalized dopamine (D2) receptor antagonists. This theory has since been expanded and modified, leading to the development of antipsychotic drugs that target the different classes of dopamine receptors to differential degrees.
NMDA HypothesisNMDA-type receptors are special receptors that use glutamate as a messenger. Some researchers are speculating that targeting NMDA receptors may alleviate positive, negative, and cognitive symptoms of schizophrenia. Normal NMDA receptor activity depends on three key factors:
Bottom line is that glycine, amino acid. It is the focus of many proposed therapies to enhance NMDA activity in the brains of people with schizophrenia.
Glycine could be the key of treatment!Several researches have proven that the use of Glycine have caused improvements of the NMDA receptor dysfunction. This is causing relieving of many symptoms, both, positive and negative!
Non-drug therapiesAlthough medications are base of the effective treatment, many people with schizophrenia also benefit from non-drug therapies. These may include:
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