Medications used with Schizophrenia

Running Head : CURRENT MEDICATIONS USED WITH SCHIZOPHRENIA

Current Research on Medications used in the Treatment of Schizophrenia

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INTRODUCTION

The introduction of drugs to the treatment of schizophrenia heralded the modern era of psychopharmacology . The French anesthesiologist Hans Labroit was the first to note the antipsychotic effects of chlorpromazine while utilizing the drug as a preanesthetic medication Medications have long been the primary component of effective treatment for schizophrenia (Denckner , 2001 . Conventional antipsychotics have

been in use since the 1950s . However , these medications have a number of unpleasant side effects

The use of the new generation of schizophrenia medications , generally known as "atypical " or "novel " antipsychotics , has increased dramatically over the past decade . The first medication in this series was clozapine , which , because of the higher risk of agranulocytosis found limited application in routine clinical practice . In 1989 , the Food and Drug Administration (FDA ) approved clozapine , the first of a new class of antipsychotic medications . Although clozapine can cause agranulocytosis , a potentially fatal blood dis that is reversible if the medication is stopped , it has far fewer of the extrapyramidal side effects typically associated with conventional antipsychotics (hence the term "atypical

Atypical agents introduced in more recent years , such as risperidone olanzapine , and quetiapine , have not been associated with an increased risk of this side effect and were shown in clinical trials to be at least as efficacious as conventional antipsychotics for schizophrenia and other psychotic diss (Remington and Chong 1999 Worrel et al 2000 . Randomized clinical trials have also shown that patients treated with these medications have fewer extrapyramidal symptoms and , as a result , have better adherence , fewer gaps in treatment , and fewer rehospitalizations (Rosenheck et al . 2000

The use of these new medications increased quickly after their approval by the FDA . By 1999 , 58 .8 of all patients with schizophrenia who received an antipsychotic in the Department of Veterans Affairs (VA were prescribed an atypical medication (Seeman et al , 1996 , and the proportion had increased to 64 .4 by 2000 (Wong et al , 2005 . However little is known about the process by which these medications are adopted , i .e , whether there is a simple switch to a new medication or a more complex process of trial and error

Literature Review

The history of antipsychotic drug development is closely linked to the dopamine (DA ) hypothesis of schizophrenia . This hypothesis postulates that schizophrenia is associated with a dis in DA neurotransmission based on several observations

Dopamine agonists , such as d-amphetamine , bromocriptine , and l-DOPA can

exacerbate symptoms in schizophrenic patients and can produce psychotic

symptoms in non-schizophrenic persons

2 . All currently used antipsychotic drugs share the common property of D2

dopamine receptor blockade both in vivo and in vitro

A correlation exists between D2 dopamine blocking potential and clinical antipsychotic efficacy (Creese et al , 2006

An increase in D2 dopamine receptors in the drug-napve schizophrenic brain has been reported but this finding has not been replicated (Wong et al , 2005...