What treatments are available for schizophrenia and are they effective?

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What treatments are available for schizophrenia and are they effective?

Introduction

Schizophrenia is a psychotic mental illness in which sufferers lose touch with reality by seeing, smelling or feeling things that don’t exist, hear threatening voices and become extremely paranoid. Around 1 in 100 people will develop the disorder at some stage during their lives, however a quarter of these will only experience one episode (1). This statistic and the fact that schizophrenia costs around £3.6 billion pounds per year for the NHS means that it is a huge scale problem, and needs to be treated to help people with the disorder live a life that is as normal as possible.

                                        

A chart to show the prevalence of schizophrenia in comparison to other similar illnesses.      

(3)

                                                                                 

Causes of schizophrenia

The exact cause of schizophrenia is unknown, although it is thought that the balance of certain neurotransmitters, which are needed to pass messages between brain cells, is altered and this may cause the symptoms of schizophrenia.

Genetic factors are also thought to be important, for example a close family member of a schizophrenic sufferer has a 1 in 10 more chance of also developing the disease, which is 10 times the normal probability; however several factors appear to need to be present to trigger the condition. (11)

These include stress, viral infection in early childhood, a lack of oxygen during birth, and the use of illegal or ‘street’ drugs. (2)

Biological treatments for schizophrenia

Over the past few years, many different medications have been developed for use in the treatment of schizophrenia which are referred to as neuroleptics or antipsychotic drugs and were developed in the 1950s.

Antipsychotic drugs alter the balance of neurotransmitters and are used to relieve the symptoms of schizophrenia and to prevent relapses, meaning that antipsychotic medicine is usually taken on a long-term basis. There are two types of antipsychotics- first and second generation, with the first generation being the older type of drug. (3)

These drugs work by blocking the action of the neurotransmitter dopamine in the brain by binding to it, but without stimulating the dopamine receptors. The atypical antipsychotic drugs, such as clozapine, act by only temporarily occupying dopamine receptors, and then rapidly dissociating to allow normal dopamine transmission to resume. This may explain why typical antipsychotics have lower levels of side effects compared to conventional antipsychotics. (11)

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Second-generation drugs are often referred to as atypical antipsychotics, and they include amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, aertindole and zotepine. These drugs are often used for new patients as they seem to have a good balance between the chances of success and the risk of side effects. (2)

Antidepressant drugs are also used to treat the symptoms of schizophrenia, and these work by reducing the rate of absorption of neurotransmitters back into the nerve endings, or by blocking the enzyme which is able to break down the neurotransmitters. Both of these methods increase the amount of neurotransmitter available in ...

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