page 7. Schizophrenia:
Understanding the Disorder
The New Treatments:
Thanks to an ever increasing understanding of the brain’s
mechanisms, unique treatments have been developed for schizophrenia. These therapies treat symptoms previously
untreated by older medications.
Conventional antipsychotics
are effective against the delusions and hallucinations in some individuals with
schizophrenia, but they do not control the debilitating negative symptoms such
as social and emotional withdrawal. In
addition, people taking these drugs often suffer from side effects known as extrapyramidal
symptoms (ex. Uncontrollable shaking, tremors, muscle stiffness…)
This new class of therapies treat both the positive (ex.
Delusions and hallucinations) and negative (ex. Social withdrawal, lack of
desire or motivation) symptoms of schizophrenia. And during the course of treatment they have been shown to
produce a lower incidence of side effects than older medications – especially
the serious extrapyramidal symptoms discussed earlier.
The positive and negative symptoms of schizophrenia are
thought to be caused by abnormal levels in the brain of the the
neurotransmitters, including both dopamine and serotonin. Brain messengers like serotonin and
dopamine, carry messages from certain specific nerve cells to other cells, or
receptors, in the brain. Researchers
have suggested that people with schizophrenia have too many dopamine receptors
in certain areas of the brain, or else they have receptors that are overly
sensitive to dopamine. So in the brain
of a person who has schizophrenia, too many messages may be sent along these
communication pathways.
Conventional antipsychotic drugs work by blocking dopamine
receptors on brain cells that use this chemical as a neurotransmitter. It is believed that abnormal levels of dopamine
are responsible for the positive symptoms of schizophrenia.
New treatments, called Serotonin-Dopamine Antagonists,
work differently. Not only do they
block the dopamine receptors, they also block serotonin receptors in specific
areas of the brain. These two
receptors appear to interact with each other, and drugs which influence both
seem to be able to treat both the positive and negative symptoms of
schizophrenia.
Because of this unique mode of action, side effects that are
seen with conventional antipsychotics -
ex. Uncontrollable shaking, tremors and muscle stiffness… are greatly
reduced. So, many individuals with
schizophrenia find these drugs easier to live with.
How to Talk to Your Healthcare Professional about
Medication:
Learning as much as possible about the disorder, the
treatments available, and the side effects of the drugs used in the treatment
is important.
Asking questions of your doctor is justifiable, considering
the nature of the disorder and the course of treatment. Open-ended questions like “what do you think
about the new treatments?” will enable the person with schizophrenia and
perhaps their family/caregivers to discuss new treatments. Arriving at the best antipsychotic
medication and the right dose of that medication should always be a shared
effort between the doctor and person with schizophrenia. So if there are concerns about current
treatments, whether due to side effects, or lack of symptom control (positive
and/or negative) talk to your healthcare professional.