Schizophrenia Medication Treatment Options

Medication

Although there is no cure for schizophrenia, it is successfully treatable with a combination of antipsychotic medications and supportive counseling. Though both therapy modalities are important, medication is the more important means of therapy; the only therapy that can effectively reduce acute symptoms. Psychosocial therapies delivered in isolation from antipsychotic medication will not help schizophrenic patients all that much.

The efficacy of antipsychotic drugs is well-established. These medications can make symptoms milder, shorten the course of an episode, and increase the time between psychotic episodes. These drugs are not perfect tools, however. Studies show that while approximately 70% of patients improve while on these drugs, about 25% show only minimal improvement and about 5% actually deteriorate.

Antipsychotic or neuroleptic medications affect brain chemicals called neurotransmitters that enable communication between the nerve cells making up the brain. Schizophrenia symptoms (at least positive ones) appear to result from problems with multiple neurotransmitter systems, including dopamine, serotonin and glutamate, and the antipsychotic medicines appear to correct or minimize these problems (see "Evidence That Schizophrenia is a Brain Disease" above).

Although antipsychotic medications are effective in treating schizophrenia, not all medications are equal, and there is no single best treatment protocol. Different patients respond best to different types and dosages of medicine. The potential for side effects must be factored in too, as antipsychotic medicines have numerous side effects (some quite serious in nature - see discussion below). Medicine and dosage must be individually determined and balanced for each patient being treated. These kinds of medication determinations take time to get right and can only be made by a psychiatrist or allied medical professional working under the supervision of a psychiatrist. An antipsychotic medication can take weeks or even months to start working at full strength, so patience on the part of the clinician and patient is required.

Typical and Atypical Medicine Generations

Antipsychotics are divided into two categories: first-generation, also known as "typical" drugs, and second-generation, also known as "atypical" drugs and dopamine partial agonists. Typical antipsychotics are so-called because they were the first family of drugs discovered to have antipsychotic properties. Some examples of "typical" antipsychotic medications are: chlorpromazine, fluphenazine, haloperidol, molindone, thiothixene, thoridazine, trifluoperazine, and loxapine. Atypical antipsychotic drugs were developed later on and named to distinguish them from the earlier drugs. Some examples of "atypical" antipsychotic medications include: clozapine, olanzapine, risperidone, quetiapine, ziprasidone, and aripiprazole. The distinction in these drug category names also reflects differences in how they were thought to work. Typical medications were originally thought to work primarily by affecting dopamine, while atypical drugs were thought to work through other neurotransmitter systems. Recent research suggests that all of these drugs mainly affect dopamine systems, however.

Even though all antipsychotic medicines work through dopamine, atypical medications can offer some advantages over typical medications. Atypical medications seem to produce greater negative symptom relief, less cognitive impairment, better relapse prevention and functional capacity, fewer extrapyramidal symptoms (EPS; see discussion below), and less tardive dyskinesia (TD). These are significant advantages and suggest that where tolerated and appropriate, atypical medication therapy may result in a better quality of life for those living with schizophrenia.

Comments
  • Dean

    have fully read your outlines on schizophrenia and have educated my self to the best that i can and also im very curios on the treatment topic of medicines you explain that typical antipschosis medication were the first generation bleived to help the neurotransmitters in the brain and to calm the hallucinations and dillusions in a persons case and that atypical antiphsychosis are found and named in a later version of the first generation and also has a greater relapse prevention and so on but you also mention the word 'dopamine' wich has had no prior information on that word and therefor i could not understand the last two paragraphs, if you would please either send a short email to the address above explaining what the word meant it would be hugely appreceiated all my regards dean

    Editor's Note: Dopamine is a neurotransmitter chemical in the brain. This means that it is a naturally occuring chemical in the brain which is essential in helping nerves send signals from one place to another. There are many different kinds of neurotransmitters in the brain, Dopamine being only one of them. Others include Epineprine, Norepinephrine, Serotonin, and GABA. Problems with Dopamine seems to be particularly important in the maintainance of Schizophrenia. When too much Dopamine is present, people hallucinate. When not enough is present, people develop Parkinson's Disease symptoms. It's more complicated that this - more than Dopamine is involved, but this little bit of information should help you understand what the antipsychotic drugs do, which is (amoung other things) to regulate Dopamine and other neurotransmitters involved in producing symptoms of Schizophrenia.

  • Hopeful

    Are doctors and family allowed to adopt out a persons child while that person is having psycosis for instance if someone is pregnant are they allowed to adopt out the child without the person agreeing to it?

    The other question I have is when someone starts out with schizophrenia is it possible for the only symptoms to be while they are sleeping for instance being afraid to sleep because when they do they are woke up and have terrible experiences feeling like they are drugged and can't do anything about the problem but afraid to tell whats going on because of the fear becuase they have been threatened and after probably 4 months they start hearing some voices but they are really stressed by then and are really scared. Is this schiz or some sort of other problem. Could it be hypnagogic problems? She/ He has been diagnosed Help please.

  • shockwave

    I never had symptoms till starting antipsychotic. Now I have migraines nausea vomiting, I never I repeat never have appetite. I also developed muscle problems like I have had a cramp in my elbow for almost a year. The doctors did a biopsy and genetic testing and they found the medication to have caused a cellular dysfunction in my muscles and most likely throughout the rest of my body and organs that is responsible for my symptoms and their is no cure. The genetic testing ruled out all known muscle diseases caused by genetics or genetic mutations, or inheritance, the doctors concluded the medication is probably the cause.

  • jennie

    my boyfriend takes quetiapine, seroquel is that drug used for onlt skitzophrenia or is it also used for drug induced early psysosis? i dont really care if it is used for skitzophrenia only i love my boyfriend with all my heart i am just curious as to know wether or not its for just one? if you know the answer please comment.

    sincerely, jennie

  • Ashok Kumar Poddar

    somebody please help me diagonise my wife who is being treated for schizophernia. The kind of behaviour she is having is that she goes in deep depression and stops communication. She starts responding slowely to any person who talks to her and looses complete sleep. If no medication is provided, she loses control of her self and becomes uncontrollable where by she is shouting to things of the past which are not to her liking. Is this schizophernia or some other disorder. We are married for the last 10 years but only after the birth of my son 2 years back has she developed these symptoms. Is there any cure for this behaviour. I need guidance.

  • i hate psychiatrists

    i was forcefully injected with piportil 150mg in hospital. after coming out and being off it for 6 months i have lost all cognitive abilities. i can't face my friends anymore, i don't have any thoughts, i have memory loss and can't sleep at all. it has ruined my life and these psychiatrists are criminals.

  • Susan

    How can the article maintain that schizophrenia is successfully treatable when only 70% of patients improve? The article states: "These drugs are not perfect tools, however. Studies show that while approximately 70% of patients improve while on these drugs, about 25% show only minimal improvement and about 5% actually deteriorate." The remaining 30% of patients are in dire need of new medications that will work for them. It's very damaging to perpetuate this misperception that schizophrenia is "under control", if only patients find the right medication and stick with it. There must be over 500,000 people in the US alone who are in dire need of help. We need to remind society and medical researchers that much more needs to be done, and that more schizophrenia treatment options are urgently needed.

  • David Brown

    Did I say self awareness? wow!

    after a life of chaos child abuse drug abuse and general wrong life choices,I hit the mental wall and was diagnosed with paranoid schizophrenia.I was in a bad way and obviously needed meds.I was prescibed risperdal,what a mistake until this point although obviously delusional etc I had no suicidal tendancies.Risperdal changed this,I was impotent and would wake each day in a suicidal state,I was in a residential home and would spend hours walking around the pool table in a state of fear and anxiety.Eventually I had had enough and stopped my meds.Inevitably this led to a second hospitalisation and 28 day section.

    This time however I was prescribed flupenthixol the difference was marked although i still had some of the parkinsons type symptons connected with this type of drug they were no way as bad.The impotence had gone and so did the suicidal thoughts. This time I kept taking my meds. until i felt confident enough to start weening myself of of them.I would not reccomend doing this unless you are completely aware of your condition and accepting that it exists or existed.My doctor was unsure but agreed to support me.That was in 2001 I have been stable since.I have two children that I was caring for on my own nad have managed to straighten my life to a better place than i was before my episodes.

    I guess my reason for commenting here was to give people a little hope during what is a daunting time when the future may seem so hopeless.