Aggression schizophrenia

The molten carbonate fuel ceU uses eutectic blends of Hthium and potassium carbonates as the electrolyte. A special grade of Hthium carbonate is used in treatment of affective mental (mood) disorders, including clinical depression and bipolar disorders. Lithium has also been evaluated in treatment of schizophrenia, schizoaffective disorders, alcoholism, and periodic aggressive behavior (56). 

Psychiatric signs euphoria, dysphoria, agitation, hallucinations, delusions, aggression, violence, bizarre behavior, schizophrenia-like body trip ... 

People with schizophrenia may appear uncooperative, suspicious, hostile, anxious, or aggressive due to their misinterpretation of reality. They may have poor hygiene and appear unkempt, as psychosis, as well as depressive symptoms, may lead... 

Since early detection and intervention in schizophrenia is important for maximizing outcomes, treatment with antipsychotic medications should begin as soon as psychotic symptoms are recognized. Antipsychotic medications are the cornerstone of therapy for people with schizophrenia, and most patients are on lifelong therapy since non-adherence and discontinuation of antipsychotics are associated with high relapse rates. If other symptoms are present such as depression and anxiety, these symptoms should also be aggressively treated. Additionally, psychosocial treatments should be used concomitantly to improve patient outcomes. 

A variety of kinds of evidence have linked emotional behavior to hormones. Two conditions, the menstrual cycle and menopause, have been the focus of a great deal of research on human behavior. In addition, gender differences in the prevalence of mental illnesses have been used as indirect evidence for possible hormonal effects on emotional disorders. For example, depression is more common in women than in men. In contrast, a pubertal onset of schizophrenia is more common in males than females (Hafner, et al., 1993), although the lifetime occurrence of schizophrenia is approximately equal in men and women (Seeman, 1996). Effects of hormones on emotional lability in men are described above in the context of aggression. 

Tsai, S. J., Chiu, H. J., Wang, Y. C., and Hong, C. J. (1999) Association study of serotonin-6 receptor variant (C267T) with schizophrenia and aggressive behavior. Neurosci. Lett. 271, 135-137. 

Molindone is a more active antipsychotic than chloropromzine. Its sedative effect is less expressed. Side effects are also expressed less than with powerful neuroleptics. It facilitates the reduction of spontaneous movements and aggressiveness, and is used for treatment of psychotic disturbances, particularly in cases of chronic and severe schizophrenia. A synonym of this drug is moban. 

Indications include a wide variety of psychiatric disorders, in the first place schizophrenia, organic psychoses and other acute psychotic illnesses. However they are also of use for the manic phase of bipolar affective disorder and for psychotic depression. Under antipsychotic drug therapy patients become less agitated and restless, withdrawn and autistic patients may become more communicative, aggressive and impulsive behavior diminishes and hallucinations and disordered thinking disappear. 

Some of the earliest studies of psychotropic medications in preschool-age children involved neuroleptics. In autism, antipsychotics are the most frequently used psychoactive agents for the reduction of stereotypies, temper tantrums, aggressiveness against self or others, and hyperactivity (Campbell et al., 1999). There are seven studies with preschoolers with a total subject number of 59. Each of these seven studies involved medication trials with preschool children diagnosed with autism or childhood schizophrenia (Table 49.5). Only one study was a randomized, double-blind, pla-... 

Evidence indicates that the long-term outcome for a patient with schizophrenia is better when treatment of the acute episode is initiated rapidly. After a patient s first psychotic episode, treatment with the antipsychotic medication should be continued for at least 1 year after a full remission of psychotic symptoms. A trial period without medication may then be considered, except for patients with a history of serious suicide attempts or violent aggressive behavior... 

Treatment of psychosis (schizophrenia) Schizophrenia is a split mind or splitting of perception from reality. The patient of schizophrenia is dissociated from the world around him and lives in their own world which is characterized by aggression, anxiety, restlessness, hallucinations and delusions. Phenothiazines reduce the hallucinations, aggression, anxiety and make them acceptable and cooperative. 

While the role of lithium in treating schizophrenia has not been well delineated, it may be useful in certain patients with aggression, agitation, or psychomotor excitement. Most, however, do not believe it has inherent antipsychotic properties. Clinical evidence from a small number of controlled trials finds lithium alone is not beneficial for process schizophrenia. For example, an earlier double-blind, controlled trial of lithium versus CPZ for chronic schizophrenics found lithium completely ineffective and possibly harmful in the more chronic patients, while the antipsychotic had its expected beneficial effect ( 372). 

Propranolol may have specific antiaggressive effects for mentally retarded, organic, and certain schizophrenic patients with episodic violence. High-dose propranolol in patients with episodic aggression has been recommended, but this is based primarily on case reports. These indications should be distinguished from its use with or without an antipsychotic as a specific treatment for schizophrenia. For example, some open studies using high doses of propranolol (i.e., 500 mg to 2 g) reported success in an occasional schizophrenic patient, but not all studies confirmed this outcome ( 397, 398, 399, 400, 401, 402, 403 and 404). 

Sorgi PJ, Ratey JJ, Poiakoff S. Beta-adrenergic biockers for the controi of aggressive behaviors in patients with chronic schizophrenia. Am J Psychiatry 1986 143 775-776. 

Both typical (e.g., haloperidol) and atypical (e.g., clozapine) antipsychotics are used in children and adolescents, primarily to treat schizophrenia, psychotic mood disorder, and pervasive developmental disorders. These agents are also used on occasion to treat a range of other conditions including conduct disorder, impulsive and aggressive disorders, Tourette s disorder, and ADHD. 

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