Treatment Of Schizophrenia

Treatment of schizophrenia is aimed at decreasing dopaminergic activity in the brain. That is, the flow of the neurotransmitter known as “dopamine”. In particular in the brain areas belonging to the limbic system and the nigrostriatal nucleus.

In this article we share all the information related to the treatment of this disease. Read on to learn about existing drugs and their possible adverse effects. 

Treatment of schizophrenia

To begin with, why decrease dopaminergic activity in the brain? By reducing dopamine motor functions are reduced. This is able to appease the patient.

In addition, let us remember that the limbic system is in charge of regulating physiological responses. Thus, by regulating dopamine secretion, the dopaminergic hyperactivity characteristic of schizophrenia is balanced.

On the other hand, the neurotransmitter called serotonin (5-HT) has been related to schizophrenic disorder. This exerts a modulating function on the dopaminergic pathways. Thus, many antipsychotics, in addition to blocking dopamine receptors, also act as agonists or antagonists of different serotonergic receptors.

The drugs used for the treatment of schizophrenia can be divided into:

• Typical or classic antipsychotics.
• Atypical antipsychotics.

Typical antipsychoticotics

Notably, the prototype of typical antipsychotics is chlorpromazine. Despite being the first to be developed, it is still widely used.

Now, when it comes to drugs in this category, they  are only effective against positive symptoms of the disease. For example:

• Hallucinations
• Paranoid delusions.
• Abrupt behavior.
• Thought disorganization.

Other effects

However, antipsychotics have marked extrapyramidal effects ; that is, they can cause movement and muscle control problems throughout the body.

Therefore, they can cause a transient type of Parkinson’s, which is why they are contraindicated with antiparkinsons. On the other hand, antipsychotics also produce neuroleptic effects.

Classification

The general classification of these drugs is as follows:

• Phenothiazines (such as Chlorpromazine or Fluphenazine).
• Butyrophenones ( Haloperidol – which is included in the WHO essential medicines list).
• Thioxanthenes ( Flupentixol).
• Phenothiazine analogs  (C lotiapine).

Atypical antipsychotics

These drugs are the most used in the treatment of schizophrenia. They are effective on both positive and negative symptoms of the disease. For example:

• Dementia.
• Impaired emotional responses.
• Social inhibition and isolation.

Other effects

They present an extrapyramidal syndrome less than typical. This happens because they block the D3 and D4 receptors in the mesolimbic and mesocortical pathways. And these are not related to this syndrome. This is a great advantage because they can be combined with antiparkinsonians .

Clozapine gave rise to this group of drugs. It has a serious side effect and that is that it produces agranulocytosis (low white blood cell count). Therefore, this drug is a medicine under special medical control. Apart from clozapine , they are also used:

• Sulpiride.
• Pimozine.
• Clozapine analogs .

The newer antipsychotics also affect serotonin receptors, so they do not produce extrapyramidal effects. And due to their interaction with both neurotransmission systems, they are more effective as antipsychotics.

Classification

Now, among the new antipsychotics most used for the treatment of this disease we find:

• Ziprasidone.
• Amisulpride.
• Aripiprazole.
• Paliperidone.

Antipsychotic treatments have allowed most patients to live in a community. But the treatment of schizophrenia, apart from drugs, must consist of  combining drug treatment with psychotherapy to ensure that the patient lives in the best possible way.

Does psychotherapy work in treating schizophrenia?

Psychotherapy consists of a series of measures whose objective is to ensure the psycho-emotional well-being of individuals. These measures can be carried out both individually and together. In the case of treating schizophrenia, psychotherapy is very effective when the patient has family support.

The patient should be taught to better understand their pathology and to use their own resources to achieve a better life. In addition, it is also important for the psychiatrist to keep the family members with whom the patient lives well informed.

Especially about the symptoms of schizophrenia. This way, the patient can be prevented or assisted if necessary.

On the other hand, it is very important that the doctor and the therapist maintain a good relationship with the patient. The objective is that this can feel comfortable when following the guidelines that are indicated.

What is it based on?

Now, the treatments are divided according to the type of schizophrenia that the patient presents. Although all of them take into account the following aspects:

• Social perception. It consists of the patient describing and interpreting how he feels when faced with a social stimulus.
• Cognitive differentiation. It consists of improving the level of attention and formation of verbal concepts.
• Verbal community.  Conversation skills are improved.
• Work on situations in which the patient suffers from a psychotic outbreak.
• Ability to solve problems, among other social skills.

No therapeutic element should be underestimated. The sum of all of them will help the patient to lead a much more stable life. However, it has been shown that psychoanalytic psychotherapy techniques seem not to be effective in the treatment of schizophrenia.