Schizophrenia drug therapy

The discovery of the activity of the phenothiazines such as chlorpromazine (44) against schizophrenia pointed the way to drug therapy of diseases of the mind. The intensive... 

Davies LM, Drummond MF (1993). Assessment of costs and benefits of drug therapy for treatment-resistant schizophrenia in the United Kingdom. Br JPsychiatry 162, 38-42. 

Cookson JC, Sachs GS (1999). Lithium clinical use in mania and prophylaxis of affective disorders. In Buckley PF, Waddington JL, eds, Schizophrenia and Mood Disorders The New Drug Therapies in Clinical Practice. Oxford Butterworth Heinemann. 

Voruganti, L. N. P. 8t Awad, A. G. (2002). Personal evaluation of transitions in treatment (PETiT) a scale to measure subjective aspects of antipsychotic drug therapy in schizophrenia. Schizophr. Res., 56, 37-46. 

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 Under antipsychotic drug therapy patients become less agitated and restless, withdrawn and autistic patients may become more communicative, aggressive and impulsive behavior diminishes and hallucinations and disordered thinking disappear. 

The drug therapy of depression differs in a number of critical points from that given to schizophrenics. Depressions are phasically occurring deviations from the norm that, in the majority of cases, show spontaneous remission, although this often may be only after a period of some months. The majority of depressives can be treated as outpatients a fact that explains why the illness generally does not make as severe an encroachment into the family and social surroundings of the patient as does schizophrenia. Outsiders are able to imagine what a depression must be like, or at least believe that they can everyone is occasionally sad. disappointed or devoid of hope. In the eyes of his fellow men and women a depressive consequently tends to be a person to be pitied but not one who is necessarily mad. 

Ananth J, Parameswaran S, Flara B. Drug therapy in schizophrenia. Curr Pharm Des. 2004 10 2205-2217. 

Research into the benefits of drug therapy in clinical settings for the treatment of psychosis, schizophrenia, and other mental ailments was in large part responsible for the widespread use of MDMA during its introduction. The empathic properties associated with MDMA, giving users a sense of heightened emotional attachment and connectedness, made its use very intriguing for psychotherapists. 

Casey, J. E, Bennett, I. E, Lindley, C. J., Hollister, L. E., Gordon, M. H., Springer, N. N. 1960a, Drug therapy in schizophrenia. A controlled study of the relative effectiveness of chlorpromazine, promazine, phenobarbital, and placebo, Arch.Gen.Psychiatry, vol. 2, pp. 210-220. 

A 66-year-old man with schizophrenia took zuclopenthixol 10 mg tds for 18 days and developed a mild leukopenia (2.9 x 109/1) and thrombocytopenia (109 x 109/1). He was asymptomatic, with no evidence of infection or a bleeding tendency. Zuclopenthixol was withdrawn, without any change in the rest of his drug therapy (glibenclamide 5 mg tds, biperiden 2 mg bd, oxazepam 10 mg tds, dipyridamole 75 mg tds, and ranitidine 150 mg/day). The leukocyte and platelet counts rose over the next 5 days. 

Leonard BE, Richelson E (2000) Synapdc effects of anddepressants. In Schizophrenia and Mood Disorders The New Drug Therapies in Clinical Pracdce (Buckley PF, Wadding ton JL, eds), pp. 67-84. B os ton B u tierwor th-Heinemann. 

Awad AG. Drug therapy in schizophrenia Variability of outcome and prediction of response. Can J Psychiatry 1989 34 711-720. 

The pharma-component in general is a small part of the overall costs of providing treatment. Plum-ridge (1990) found that the rank order of antibiotics costs used in secondary (hospital) care was quite different from a ranking based on the whole drug therapy. Davis and Drummond (1994) showed that the costs of pharmaceutical drugs only accounted for 3% of the total cost of managing schizophrenia the major costs were for the supervision and hospitalization of the minority of the seriously ill. 

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