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How is it treated?
Schizophrenia symptoms are thought to be
the result of an imbalance/dysregulation of neurotransmitters and degenerative brain
changes. Medications to treat schizophrenia
work by either decreasing the availability of the neurotransmitters or decreasing
production of them. There are several
classes of medications used, each with significant side effects.
The following is by no means a comprehensive list, but can provide general
information about schizophrenia medications.
Any medication used to treat schizophrenia should never be stopped abruptly
because it can trigger a severe relapse.
Typical Antipsychotics:
this class of medications blocks dopamine
transmission in the brain. This class
of medications has many side effects, some of which can lead to long-term problems
or death. As a medication class, the
following side effects exist: akathisia
(a burning desire to move a body part), oculogyric crisis (the eyes roll back into
the head), torticollis (the neck is pulled to one side), retrocollis (the neck is
pulled back, forcing the person to continually look up), tardive dyskinesia (movements
that include lip smacking, sucking, puckering, tongue protrusion, choking sensation,
jerking movements of the fingers or toes), orthostatic hypotension (a drop in blood
pressure when sitting up in bed or standing that can cause dizziness or falls),
lactation, gynecomastia (breast development in men), menstrual irregularities, sedation,
blood dyscrasias (essentially problems with blood elements that can lead to significant,
life threatening infections), neuroleptic malignant syndrome (muscle rigidity, high
fever, changes in heart beats-life threatening) and weight gain.
Due to the extensive side effects of this class of drugs, they aren’t as
frequently prescribed as they were in the past.
For each individual drug there are additional side effects that are specific
to that drug.
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Brand name/Generic name
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Typical use
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Side effects
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Thorazine/chlorpromazine
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Symptom management for schizophrenia to
control excessive anxiety, agitation and hallucinations/delusions/illusions
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Generalized swelling, lupus-like symptoms,
changes in heart beat, heartburn, headache, insomnia, blurred vision, urinary retention
(have to pee, but can’t), hives.
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Haldol/haloperidol
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Symptom management for schizophrenia to
control excessive anxiety, agitation and hallucinations/delusions/illusions
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Euphoria (feeling really good), depression,
agitation, hyperthermia (feverish), grand mal seizures, in some cases can make symptoms
worse.
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Trilafon/perphenazine
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Symptom management for schizophrenia to
control excessive anxiety, agitation and hallucinations/delusions/illusions
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Blurred vision, near-sightedness, constipation,
abnormal liver function, photosensitivity, itching, fever, sterile abscesses, congestion,
decreased sweating.
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Prolixin/fluphenazine
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Symptom management for schizophrenia to
control excessive anxiety, agitation and hallucinations/delusions/illusions
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Depression, impaired body temperature regulation
(the person may not recognize the need for a coat for example), photosensitivity,
congestion, dry mouth, nausea, urinary retention.
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Atypical Antipsychotics:
these blocks dopamine and serotonin
transmission in the brain. As a class
of medications, this group is known to cause significant weight gain which leads
to the development of type II diabetes.
Cardiac arrhythmias and dysrhythmias (missed or skipped heartbeats) and blood dyscrasias
(anemias which can be fatal) have also been linked with this class of drugs.
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Brand name/Generic name
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Typical use
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Side effects
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Zyprexa/olanzapine
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Symptom management for schizophrenia to
control excessive anxiety as well as treat problems with depression, motivation,
apathy and anhedonia
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Back & chest pain, swelling of the
fingers, toes, or legs, joint pain, muscle twitching, stuttering, hypotension, constipation,
dry mouth, increased saliva, vomiting, PMS, bloody urine, incontinence cough or
rash.
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Seroquel/quetiapine
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Symptom management for schizophrenia to
control excessive anxiety as well as treat problems with depression, motivation,
apathy and anhedonia
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Swelling of the hands and feet, flu-like
symptoms, dry mouth, joint pain, constipation, lack of interest in eating, cough,
difficulty breathing, rash, sweating, headache, dizziness, stomach pain.
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Risperdal/risperidone
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Symptom management for schizophrenia to
control excessive anxiety as well as treat problems with depression, motivation,
apathy and anhedonia
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Sedation, drowsiness, headache, blurred
vision, sweating, increased dreaming, anxiety, insomnia.
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Geodon/ziprasidone
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Symptom management for schizophrenia to
control excessive anxiety as well as treat problems with depression, motivation,
apathy and anhedonia
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Muscle aches, flu-like symptoms, facial
swelling, low body temperature (chills), tremor, confusion, double vision, nausea,
vomiting, stomach pain, heartburn, cough, difficulty breathing, rash, photosensitivity,
hypertension.
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Abilify/aripiprazole
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Symptom management for schizophrenia to
control excessive anxiety as well as treat problems with depression, motivation,
apathy and anhedonia
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Headache, tingling, fever, flu-like symptoms,
swelling of the hands, feet, or legs, chest pain, hostility, suicidal thoughts,
depression, nervousness, anxiety, muscle cramps, blurred vision.
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Clozaril/clozapine
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Limited to control of schizophrenia symptoms
in patients who have not responded to other medications.
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Risk of developing infections in the heart
muscle or heart sac within the first month of use, developing fluid around the heart,
heart failure, heart attack, heart valve problems, nausea, dry mouth, constipation,
increased saliva, agranulocytosis (a potentially fatal blood disease where the building
blocks of blood cells aren’t produced), fever, urinary retention.
This medication is a last resort medication due to its significant adverse
effects.
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More medication information?
All of the medications used to treat schizophrenia
have undesirable side effects. Finding
the right one requires a partnership with the physician.
If one medication helps the symptoms but worsens quality of life, it isn’t
the right medication for the individual.
Taking the medicine is the most important thing a person with schizophrenia can
do to prevent further decline and manage their lives independently.
Abruptly stopping any of the medications can trigger a relapse with significant
symptoms. It is possible to relapse
even while taking the medication as prescribed, however, these relapses tend to
be mild and more easily managed.
It
is possible for a person with schizophrenia to live a normal life.
They are not any more crazy, dangerous, or destructive than someone who has
a diagnosis of diabetes. The stigma
associated with schizophrenia has a misguided, historical basis that is slowly starting
to wane.
Are there any other treatments in addition to medication?
Yes.
Many people with schizophrenia benefit from support groups run by a qualified
psychiatrist. Through the group people
prevent isolation, socialize, and address issues that are stressful in their daily
lives. Cognitive-behavioral therapy
is a tool used to help with problems stemming from a lack of motivation like hygiene
issues, learning job skills, grocery shopping, etc.
Assertive Community Treatment is a program available to teach job
skills and provide employment, as well as coordinate services within the community.
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