Treatment for schizophrenia usually involves antipsychotic medication. The effectiveness of traditional antipsychotic drugs depends on the nature of the patient's schizophrenia symptoms. New "atypical" antipsychotics provide treatment of schizophrenia symptoms that are resistant to traditional antipsychotic medication. Whether traditional or atypical, learn how all antipsychotic drugs can cause serious side effects.
Traditional antipsychotic drugs, also known as antischizophrenics, major tranquilizers and neuroleptics, are the mainstay of schizophrenia treatment.
In theory, these drugs treat schizophrenia symptoms by affecting levels of dopamine, a brain chemical responsible for transmitting nerve cell signals. Antipsychotic drugs block dopamine receptors, limiting the amount of dopamine available to nerve cells. Dopamine imbalances are a possible cause of schizophrenia.
Critics of this theory point out that antipsychotics block dopamine receptors quickly, but their benefits aren't apparent until after weeks of treatment. If antipsychotic drugs don't treat schizophrenia by blocking dopamine, the medications may affect other brain processes to relieve schizophrenia symptoms.
Antipsychotic drugs are most effective in patients with predominantly "positive" schizophrenia symptoms. These symptoms are generally absent in people without mental illness, including delusional thinking, disorganized speech and hallucinations.
"Negative" schizophrenia symptoms, on the other hand, include thoughts and behaviors that may present in people without mental illness. These symptoms, including dulled emotions, impaired visual ability, inattention and loss of motivation, don't respond as well to traditional antipsychotic drugs.
Schizophrenia treatment options expanded with the development of atypical antipsychotic drugs. While traditional antipsychotics block dopamine receptors, many atypical antipsychotic medications block both dopamine and the neurotransmitter serotonin.
Serotonin imbalances are linked to depressive mood disorders, which have symptoms that are similar to negative schizophrenia symptoms. This may explain why atypical antipsychotics are more effective in patients with mostly negative symptoms.
All medicinal treatment for schizophrenia can produce side effects, such as:
When antipsychotic drugs block dopamine receptors, the brain may not be able to access sufficient dopamine. This can cause Parkinson's-like side effects, including stiffness, shakiness and slow movement. These side effects may be minimized by combining antipsychotics with anticholinergic drugs that block the neurotransmitter acetylcholine.
Long-term treatment for schizophrenia may result in tardive dyskinesia, a condition marked by compulsive chewing movements, lip puckering, lip smacking and tongue rolling. Although these symptoms usually cease when antipsychotic drug treatment is discontinued, they can be permanent. New treatment for schizophrenia, most notably the atypical antipsychotic, risperidone, may reduce the risk of tardive dyskinesia.
Fauci, A., Braunwald, E., Isselbacher, K., Wilson, J., Martin, J., Kasper, D. ...
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