Medication schizophrenia

In 1976, Ian Creese, David R. Burt, and Solomon H. Snyder of Johns Hopkins University in Baltimore, Maryland, reported that the most effective schizophrenia medications are the ones that have the strongest affinity for dopamine receptors. Researchers also discovered drugs that increased the amount of dopamine inadvertently caused schizophrenic symptoms in patients. These findings led to the dopamine hypothesis of schizophrenia—too much dopamine causes schizophrenia. 

Fritzsche, M. (2000) Are caimabinoid receptor knockout mice animal models of schizophrenia. Medical Plypothesis 56, 638-643. 

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. 

C. The symptoms are not due to a general medical condition (e.g., anatomical lesions and infections of the brain, visual epilepsies) and are not better accounted for by another mental disorder (e.g., delirium, dementia. Schizophrenia) or hypnopompic hallucinations. 

George TP, Ziedonis DM, Feingold A, et al Nicotine transdermal patch and atypical antipsychotic medications for smoking cessation in schizophrenia. Am J Psychiatry 157 1835-1842, 2000... 

Grainger DL, Hamilton SH, Genduso LA, et al (1998a). Medical resource use and work and social outcomes for olanzapine compared with haloperidol in the treatment of schizophrenia and other psychotic disorders. Poster presented at the 21st Congress of the CINP, Gla ow, July 1998. 

Changes in perceived physical and mental health status of a schizophrenia patient population following initiation of a conventional or an atypical antipsychotic medication. Poster presented at the American Psychiatric Association Annual Meeting, Toronto, June 1998. 

The cornerstone of treatment is antipsychotic medications. Because most patients with schizophrenia relapse when not medicated, long-term treatment is usually necessary. 

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. 

Be clear that there is no cure for schizophrenia and that medications only help to decrease the symptoms. 

Stress the importance of medication and treatment adherence for improving long-term outcomes in schizophrenia. 

Opolka etal. (2003) examined Texas Medicaid claims for patients with schizophrenia or schizoaffective disorder during the period of January 1996 to August 1998. These patients had been initiated to treatment with either haloperi-dol or olanzapine and had no previous use of these medications in the year prior (total, n = 2601 haloperidol, n = 726 olanzapine, n = 1875). 

Opolka, J. L., Rascati, K. L., Brown, C. M., Barner, J. C. et al. (2003). Ethnic differences in use of antipsychotic medication among Texas Medicaid clients with schizophrenia. /. Clin. Psychiatry, 64, 635-9. 

Fenton, W. S. Chavez, M. R. (2006). Medication-induced weight gain and dyslipidemia in patients with schizophrenia. Am. J. Psychiatry, 163, 1697-704. 

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