Treatment for Schizophrenia

In current clinical medicine at this stage, the results support a diagnosis of schizophrenia not only based on a clinical history, but also on the presence or absence of psychotic symptoms.

Since we all have experienced, we all may agree that there is something within our culture and our environment that makes schizophrenia’s evolution more difficult to prevent. For some, this may have been true even before our evolutionary history has taken place and it is perhaps the presence of the dopamine hypothesis. If there is no real or imagined ‘evolutionary advantage of schizophrenia, then why did it evolve in the first place? The fact is, in a way, both a real and a perceived ‘evolutionary advantage’ may be present. Perhaps schizophrenia's evolutionary advantages or disadvantages are more a source of conflict or conflict resolution than it’s being a biological disease ‘by-product’ of evolution.

Schizophrenia is a mental illness characterized by abnormal thinking, behavior, and social relationships. Schizophrenia is a chronic disorder and is usually lifelong. Although the rate remains the same for males and females, males are typically diagnosed earlier and have a more severe course when diagnosed than females. Schizophrenia is found worldwide and most commonly occurs in adolescence or early adulthood in the West.\n

The first psychotic episode can occur already by the age of 16 in about half of all adolescents. Men and women have similar lifetime rates of psychosis. The rate per 100,000 inhabitants per year is 1.3 for men and 1.1 for women.

Symptoms included hallucinations, delusions, disorganized speech, difficulty in maintaining attention, and lack of emotional control. Symptoms can last for days or even months, and appear, resolve and reappear to a varying extent. Symptoms can differ for those with the schizophrenic or schizoaffective disorder.

The current focus of psychiatric treatment is mainly symptomatic and is based on an exclusionary approach. Attention focused on the individual, the community, and research could lead to a shift from a conventional psychiatric model in the treatment of schizophrenia towards a'systems approach'. Inclusion of interpersonal components in psychiatric care could enable a better assessment of quality of life and reduce the risks associated with 'adverse' drugs' and medication side-effects. It is important to address interpersonal problems such as shame and anger in psychiatric care.

There have been two other major trials evaluating clozapine in schizophrenic patients. No major difference was observed between clozapine and placebo in the primary outcome measures in either trial.

The common side effects of antipsychotic treatment include the following: extrapyramidal side effects (motor symptoms), movement disorders, sedation, tardive dyskinesia, hyperprolactinaemia, weight gain and other metabolic disorders, movement disorders, neurological effects, extrapyramidal side effects, and dyskinesia. Side effects and adverse drug reactions of antipsychotic agents are more significant than the side effects of benzodiazepines or other drugs. This situation is worsened by their pharmacokinetic and pharmacodynamic properties, and treatment of the underlying cause of the side effects that antipsychotic agents cause.

A number of potential etiologies of schizophrenia exist, and although the evidence of a single cause of schizophrenia is limited, the evidence for viral infection is strong. While the most widely accepted theory of schizophrenia is the dopamine hypothesis, it is not the only possibility in the etiology and there may be other factors at work. In particular, evidence has been reported that a common allele for mania associated with the serine protease S100B protein is associated with mania. The link between genetics and schizophrenia may be more apparent with more sensitive methods in the search for a clue to the disease mechanism.

The use of medication can have negative side effects, including an increased risk of developing cancer and of premature death. Many individuals with schizophrenia experience problems when they are deprived of medication. The lack of this crucial support can lead to further relapse. The consequences of medication are potentially disastrous; if used as is by those who are not fully qualified in proper care, some of the potentially hazardous side effects of medication will be missed. Although there is clear evidence that medication can help some people, people must be fully informed of the potential risks and the risks outweigh the benefits of treatment. Effective education about the risks and benefit of medication may have a significant effect on people's decision to continue or to discontinue medication.

Although the median age of onset for schizophrenia and bipolar disorder is ~24 years, the distribution of age at onset is decidedly skewed as compared with general populations based on studies in the US, Norway, Australia, and New Zealand. A disproportionately high proportion (~50%) of young patients will have onset of psychosis in a preadolescent age span (<15 years).