Antipsychotics schizophrenia management

Antipsychotic medications are indicated in the treatment of acute and chronic psychotic disorders. These include schizophrenia, schizoaffective disorder, and manic states occurring as part of a bipolar disorder or schizoaffective disorder. The co-adminstration of antipsychotic medication with antidepressants has also been shown to increase the remission rate of severe depressive episodes that are accompanied by psychotic symptoms. Antipsychotic medications are frequently used in the management of agitation associated with delirium, dementia, and toxic effects of both prescribed medications (e.g. L-dopa used in Parkinson s disease) and illicit dtugs (e.g. cocaine, amphetamines, andPCP). They are also indicated in the management of tics that result from Gilles de la Tourette s syndrome, and widely used to control the motor and behavioural manifestations of Huntington s disease. 

Antipsychotic, or neuroleptic drug Used in the treatment of schizophrenia. They are also used in the management of psychotic episodes associated with psychotropic drug toxicity and some neurodegenerative disorders. 

Campbell M, Young PI, Bateman DN, Smith JM and Thomas SHL (1999). The use of atypical antipsychotics in the management of schizophrenia. British Journal of Clinical Pharmacology, 4,1, 13-22. 

Only clozapine has shown superiority over other antipsychotics in randomized clinical trials for the management of treatment-resistant schizophrenia. 

Chlorpromazine is an aliphatic phenothiazine antipsychotic used in schizophrenia and which may exacerbate parkinsonism. Co-careldopa is a combination of levodopa and the peripheral dopa-decarboxylase inhibitor, carbidopa. Co-careldopa, amantadine, entacapone and bromocriptine are all indicated in the management of parkinsonism. 

Schizophrenia - For the management of severely ill schizophrenic patients who fail to respond adequately to standard antipsychotic drug treatment. 

Antipsychotics have a broad-spectrum effect, improving psychosis in schizophrenia, schizophreniform disease, mania, and organic psychosis but response to lithium suggests an affective core. Whereas almost all schizophreniform patients are presently treated with antipsychotics, it is possible that lithium may be more specific and safer in the management of at least some of these patients. 

These drugs are the only effective treatment for schizophrenia, and are also used for the treatment of other psychoses. Low-dose antipsychotics are also frequently prescribed in the management of anxiety disorders. 

Catatonic forms of schizophrenia are best managed by intravenous benzodiazepines. After catatonia has ended, antipsychotic drugs may be needed to treat psychotic components of that form of the illness, and remain the mainstay of treatment for this condition. Unfortunately, many patients show little... 

Antipsychotic Polypharmacy and Managing Treatment Resistance in Schizophrenia... 

New-onset diabetes mellitus in such patients is of particular concern, owing to the associated cardiovascular morbidity and the difficulty in managing diabetes in psychiatric patients. Soon after the first neuroleptic drugs were used, associations with weight gain and diabetes were reported (769,770). Nevertheless, even before antipsychotic drugs appeared, diabetes was observed to be more common in patients with schizophrenia (771). The rate of diabetes in patients with schizophrenia has been estimated at 6.2-8.7% (772) and at 0.8% in the general population in the USA (773). 

Antipsychotic agents, such as phenothiazines and haloperidol, have been extensively used in the elderly for the management of psychiatric disorders. These are useful in the treatment of schizophrenia and dementia, agitation, and paranoid syndrome. 

Lerner V, Libov I, Kotler M, Strous RD. Combination of "atypical" antipsychotic medication in the management of treatment-resistant schizophrenia and schizoaffective disorder. Prog Neuropsychopharmacol Biol Psychiatry 2004 28 89-98. 

Only clozapine has shown superiority over other antipsychotics in randomized clinical trials for the management of treatment-resistant schizophrenia. Symptomatic improvement with clozapine often occurs slowly in resistant patients, and as many as 60% of patients may improve if clozapine is used for up to 6 months. 

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