Schizophrenia

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Clista Clanton

Schizophrenia: Emerging from the darkness

Gesundheit & Medizin

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This is a presentation done on 4/6/11 for the Grand Rounds at Wayne State university by Pallav Pareek M.D. This presentation talks about the concept of prdrome as it is(if?) applicable to schizophrenia, and if schizophrenia is becoming more of a preventable illness as science progresses. If so what are the various ways and means in which we can accomplish this prevention. Amidst so much controversy on the issue , whether there is a prodrome for this illness or not, here I have tried to present the recent advances in this field and the recent scientific literature in this regard.

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Schizophrenia is a group of severe brain disorders in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and disordered thinking and behaviour. Contrary to some popular belief, schizophrenia is not split personality or multiple personality. The word “schizophrenia” does mean “split mind,” but it refers to a disruption of the usual balance of emotions and thinking (Mayo, 2013). Schizophrenia is a chronic condition, requiring lifelong treatment.

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CHAPTER SEVEN Antipsychotic Medications The Evolution of Treatment Many readers may begin this chapter with some familiarity with antipsychotic medications. Others may think antipsychotic medications or the research related to them has not affected their lives. These latter readers may be wrong. Have you ever taken a prescription antihistamine such as Seldane or Allegra? Perhaps got over motion sickness with a compound that included promethazine? If so, your life has been affected by research into antipsychotics. As with so many other areas of research in psychotropic medication, antipsychotics and theories about their use have been developed through combined scientific effort, clinical research, market-driven agendas, and serendipity. Let's look at some history to introduce this topic. The primary source for the following is Healy (2002). THE CURRENT IMPACT OF ANTIPSYCHOTICS In a video designed for psychiatrists (Novartis Pharmaceuticals, 1998), a young man suffering from treatment-resistant schizophrenia is shown in an inpatient setting. Although his psychotic symptoms are temporarily under control, he is so incapacitated by medication side effects that he can barely walk across a small room. His movements are jerky contractions of muscle groups that he can hardly control. Anyone who has treated clients taking conventional antipsychotic medications knows that this young man is living a worst-case scenario in which the treatment is worse than the disorder being treated. The video progresses, showing the young man at monthly intervals as he is slowly weaned off the medications causing the side effects, and gradually titrated onto a new medication (clozapine). With each passing month, we see that the young man's psychotic symptoms remain under control but that he is gradually regaining control of his body. In the final video frame, we see the same young man enjoying a game of basketball and apparently having no problems with movement or symptoms of psychosis. This was one of the first videos promoting what we describe later as an atypical antipsychotic, and at the time of their development most of us believed that clozapine and drugs modeled after its molecular structure launched another revolution in psychopharmacology. It was hoped that (as was hoped in the SSRI revolution in antidepressants) the new antipsychotics would change the way psychotic disorders are treated as well as the quality of life that patients can expect during treatment. As we will see, although newer agents do work better for some but not all people with schizophrenia, the newer agents have problematic side effects similar in impact (if different in quality) as the older agents. Also, the claims that newer medications worked better than the older ones now seem to be untrue ( Jones et al., 2006; Lieberman et al., 2005). This chapter is divided into seven sections. The first is an overview of schizophrenia and the spectrum of symptoms being treated. The second focuses on th.

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