Therapy of Schizophrenia

Schizophrenia is an endogenous psychosis of episodic character in most cases, recovery is incomplete (residual defects, burned-out end stage). The different forms of schizophrenic illness will not be considered here. From a therapeutic perspective, it is relevant to differentiate between 

The conventional (or classical) neuroleptics comprise two classes of compounds with distinctive chemical structures 1. the phenothiazines derived from the antihistamine promethazine (prototype chlorpromazine), including Ltillmann, Color Atlas of Pharmacology 2000 Thieme All rights reserved. Usage subject to terms and conditions of license. 

The antipsychotic effect is probably due to an antagonistic action at dopamine receptors. Aside from their main antipsychotic action, neuroleptics display additional actions owing to their antagonism at 

These ancillary effects are also elicited in healthy subjects and vary in intensity among individual substances. 

Other indications. Acutely, there is sedation with anxiolysis after neurolep-tization has been started. This effect can be utilized for psychosomatic uncoupling in disorders with a prominent psychogenic component neuroleptanalgesia (p. 216) by means of the buty-rophenone droperidol in combination with an opioid tranquilization of overexcited, agitated patients treatment of delirium tremens with haloperidol as well as the control of mania (see p. 234). 

It should be pointed out that neuroleptics do not exert an anticonvulsant action, on the contrary, they may lower seizure thershold. 

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Pushkareva T, Chuprikov A (1997) Use of enterosorption in combined therapy of schizophrenia. In Biosorption methods and preparations in prophylactic and therapeutic practice, First Conference, Kyiv (In Ukrainian), pp. 77-78... 

Faiioon i. Watt DC, Sheperd M. A comparative controiied trial of pimozide and fluphenazine decanoate in the continuation therapy of schizophrenia. Psychoi Med 1978 8 59-70. 

The extensive and long-term use of phenothiazine derivatives might result in unwanted or side effects. Moreover, their application as antihistaminic and/or neuroleptic drugs in the therapy of schizophrenia, organic psychoses... 

Waziri, R., 1988. Glycine therapy of schizophrenia. Biol. Psychiatry 23, 209-214. 

Anti-psychotic drugs block dopamine receptors in all four dopamine systems of the brain. Blocking of dopamine D2 receptors in the mesolimbic system is assumed to be responsible for the efficacy in therapy of schizophrenia. 

Describe the beneficial effects of clozapine in the therapy of schizophrenia. 

Mayer-Gross W. Insulin coma therapy of schizophrenia Some critical remarks on Dr. SakeTs report. J Ment Sci 1951. 97 132-135... 

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