Schizophrenia causes immense suffering for the afflicted and their families. In her 1999 book, "Night Falls Fast: Understanding Suicide," Kay Redfield Jamison, Ph.D., describes schizophrenia as the most severe and frightening of the psychiatric illnesses. Fortunately, medications called antipsychotics offer much better treatment for schizophrenia in the twenty-first century than ever before. While antipsychotics do not cure schizophrenia, many find that they help to effectively manage this chronic illness.
Neuroleptics
In 1952, thorazine became the first drug used to treat schizophrenia, paving the way for other first-generation antipsychotics, commonly known as neuroleptics. Named after their inadvertent neurological side effects, neuroleptics work by blocking dopamine, a neurotransmitter (brain chemical) implicated in causing schizophrenia. Commonly divided into high and low potency groups, some professionals also group these medications by types of side effects.
Second-Generation Antipsychotics
While neuroleptics focus singularly on dopamine blockage, second-generation antipsychotics strongly block the neurotransmitter serotonin while also producing varying degrees of dopamine blockage. The prototypical second-generation antipsychotic clozapine effectively reduces both positive and negative symptoms of schizophrenia, asserts John D. Preston, Psy.D., in his 2010 book, "Handbook of Clinical Psychology for Therapists."
Positive ("excess") symptoms refer to hallucinations, delusions and agitation, whereas negative ("lack of") symptoms include apathy, blunted affect, poverty of thought and anhedonia (an inability to experience pleasure).
Other Second-Gens
Due to certain troubling side effects of clozapine--especially agranulocytosis, a severe blood disorder that has caused several deaths in the United States--researchers produced other second-generation antipsychotics as effective as clozapine but with better-tolerated side effects. As of 2010, six other drugs are available, including risperidone, paliperidone, olanzapine, quetiapine, aripiprazole and ziprasidone.
Compared to neuroleptics, these newer drugs may help many schizophrenia patients alleviate their symptoms more effectively, and offer greater benefits: a significantly reduced risk of tardive dyskinesias (disorders involving involuntary movements), reduction of negative symptoms and improved cognition.
References
- "Night Falls Fast: Understanding Suicide"; Kay Redfield Jamison, Ph.D.; 1999
- "Handbook of Clinical Psychopharmacology for Therapists: Sixth Edition"; John D. Prestion, Psy.D.; 2010
- "Clinical Psychopharmacology Made Ridiculously Simple"; John D. Preston, Psy.D.; 2009
- "Surviving Schizophrenia: A Family Manual"; Edwin F. Torrey, M.D.; 2001
