 ◦
Philosophy
The prevailing theory in Western Medicine is that an excess of dopamine, a
neurotransmitter, causes
the symptoms. Therefore, most medicines, called neuroleptics or
antipsychotics, block the receptors for dopamine in the brain. There are a
variety of receptors, and different medicines block only some of them or block
them in different proportions.◦Benefits
Neuroleptics can decrease or eliminate symptoms in about 90% of
patients, allowing them to become more functional. This is not a cure, however,
and patients often must remain on the medicines for life.
◦Side
Effects/Warnings
The down side of neuroleptics are the numerous side effects. They include:
o
Diabetes
o
Tardive Dyskinesia
o
Heart Stroke
o
Worsen Dementia
o
Weight Gain
o
Sedation
o
Difficulty concentrating
o
Shaking
o
Rigidity
o
Impotence
These are often
so severe that patients opt to stop taking their medicine.
◦Common
Traditional Medications for Schizophrenia
Typical neuroleptics are the traditional mainstay of
antipsychotic treatment. These drugs block various dopamine receptors in the
brain. In addition to limiting psychosis, lower dopamine levels also affect the
motor system. The muscle-related side effects common to these medications are
called Extra-Pyramidal Side effects, or EPS.
◦Newer Atypical (newer)
Medications for Schizophrenia
- Aripiprazole (Abilify)
- Clozaril (clozapine)
- Geodon (ziprasidone)
- Risperdal (resperidone)
- Seroquel (Quetiapine)
·
Zyprexa (olanzapine)
Atypical
neuroleptics, also known as the "newer" drugs, all date from the introduction of
Clozaril. These drugs differ in a number of ways from the typical antipsychotics.
They exhibit dopamine D2 antagonism and serotonergic antagonism and are referred
to as a serotonin-dopamine antagonist (SDA). The atypical agents have several
advantages over the typical antipsychotic medications. These include minimal
extrapyramidal side effects, essentially no tardive dyskinesia, minimal
increases in prolactin, better negative symptom efficacy, and increased efficacy
in treatment of refractory populations (Stahl 1999).
◦Evidence
Numerous randomized controlled trials have demonstrated efficacy of
neuroleptics compared to placebo in reducing symptoms, such that now traditional
neuroleptics are considered the "gold standard" and newer treatments must be
compared to them in studies (Lieberman et al.)
Newer medicines, termed "atypical antipsychotics" have been developed and
studies suggest that they may cause less shaking and rigidity, while maintaining
efficacy (Seretti et al.)
◦Links
About.com's Mental Health Resources
National Institute of Mental Health: Medications
Schizophrenia
Treatments and Medications |
