Schizophrenia affects 2.4 million American adults each year, according to the National Institute of Mental Health. It is a chronic brain disorder characterized by bizarre delusions, hallucinations, disorganized thoughts and behavior, and the absence of normal behaviors such as facial expressions and goal-directed movements. Because schizophrenia is a biological brain disorder, its treatments primarily comprise medications that target the abnormalities in the brain. Types of medications commonly prescribed include conventional antipsychotics, atypical antipsychotics, and sometimes, certain antidepressant medications.
Conventional Antipsychotics
Available since the 1950s, conventional antipsychotics include haloperidol, trade name Haldol; chlorpromazine, brand name Thorazine; and fluphenazine, trade name Prolixin. These drugs affect the brain through various mechanisms, including the increase in number of neuronal connections and an increase in the number of support cells in brain areas involved in judgment and emotion, according to the Treatment Advocacy Center website. These drugs are long-acting and symptom relief may not appear for several weeks after the initiation of treatment.
Physicians prescribe conventional antipsychotics less frequently than they used to because of the potential for serious side effects, including the development of a movement disorder called tardive dyskinesia that may or may not be reversible, according to the Mayo Clinic website. Instead, physicians often preferentially prescribe a newer family of antipsychotic medications, known as atypical antipsychotics.
Atypical Antipsychotics
By the 1990s, scientists had successfully developed newer antipsychotic medications with milder side effects. These medications include clozapine, brand name Clozaril; aripiprazole, trade name Abilify; risperidone, trade name Risperdal; and olanzepine, brand name Zyprexa. The U.S. Food and Drug Administration has approved Abilify and Risperdal for use in adolescents, according to the Mayo Clinic website. Scientists remain less clear about the mechanism by which these medications affect the brain compared to the conventional antipsychotics, according to the Treatment Advocacy website. Limited research suggests that the atypical antipsychotics may function differently in the brain than the traditional antipsychotics.
Common side effects associated with atypical antipsychotics include weight gain, diabetes and high blood cholesterol, according to the Mayo Clinic website. However, clozapine sometimes causes a condition called agranulocytosis, a dangerous loss of white blood cells that affects the ability to fight off infections, according to the National Institute of Mental Health website. Therefore, patients on clozapine must have their blood checked every couple of weeks.
Antidepressants
Some patients experience predominant negative symptoms, demonstrating a lack of goal-directed behavior, a lack of emotional expressiveness and a lack of spontaneous speech. For these patients, additional treatment with certain antidepressants may result in improvements in these symptoms. Selective serotonin reuptake inhibitors, or SSRIs, have been found to be effective, according to Dr. Irving Kuo of the MedscapeCME website. Several researchers have evaluated the effectiveness of fluoxetine, trade name Prozac, and found some improvement in these negative symptoms. However, the antidepressants do not replace the use of antipsychotic medication.
