Schizophrenia: New Medicines

Overview of schizophrenia and atypical antipsychotics used in the treatment of schizophrenia.

From the American Academy of Family Physicians

What is schizophrenia?

Schizophrenia is a chronic, disabling illness that may be caused by abnormal amounts of certain chemicals in the brain. These chemicals are called neurotransmitters. Neurotransmitters control our thought processes and emotions. (more on schizophrenia signs, causes of schizophrenia, and schizophrenia treatment)

How do schizophrenic people think and act?

Schizophrenic people may seem different from other people. They may seem to show fewer emotions than other people. They may keep to themselves, withdrawing from social contact. At times they may seem slowed down, as if they don't have enough energy.

Schizophrenic patients may have unusual beliefs, called delusions. They may believe that others are spying on them or that they are a famous person from history. Sometimes they hear voices telling them what to do or saying things about them. Voices that others can't hear and visions others can't see are called hallucinations. A schizophrenic person's thoughts may also race through his or her mind, becoming confused and disorganized. These symptoms come and go, often occurring after stressful events.

How is schizophrenia treated?

In the past, schizophrenia has been treated with antipsychotic medicines that block the action of a brain chemical called dopamine. These medicines help control the abnormal thinking of people with schizophrenia. Unfortunately, the medicines also decrease a person's ability to show emotion and cause slowing and stiffness in the muscles. The medicines can cause other unpleasant side effects, like unusual movements of the tongue and face. This condition is called tardive dyskinesia. A dangerous syndrome, neuroleptic malignant syndrome (also called NMS) can develop in people who use these medicines. A person with NMS may have rigid muscles or a very high body temperature. He or she may even go into a coma.

What is different about the new antipsychotics?

Newer medicines (called atypical antipsychotics) for treating schizophrenia block the brain chemical called serotonin in addition to blocking dopamine. The medicines help control the abnormal thinking associated with schizophrenia. They also improve the social withdrawal and lack of emotion that make people with schizophrenia seem different even when they are not having hallucinations or delusions.

Do the newer drugs have any side effects?

Like most medicines, the newer medicines for treating schizophrenia can cause side effects. Not everyone gets these side effects. Any side effects you have will depend on which medicine your doctor has chosen for you.

While you're taking medicine to treat schizophrenia, you may need to see your doctor on a regular basis for certain tests. For example, a medicine called clozapine (brand name: Clozaril) can lower the number of white blood cells in your body. This makes it easier for you to get an infection. People taking clozapine must have their blood checked every week. Your doctor will tell you if you need to see him or her for tests.

What else should I know about these medicines?

People who take these medicines need to drink plenty of liquids. They should avoid spending too much time in the sun because they will tend to get overheated. Since these people are also more sensitive to the cold, they should dress warmly in cold weather. People who take these medicines should try to take them at the same time every day. They should not stop taking the medicine without talking with their doctor first. If they notice that their thinking problems are getting worse or if they have any unusual symptoms or fevers, they should report these problems to their doctor.

What is in the future for people with schizophrenia?

The less time people with schizophrenia have hallucinations or delusions, the better they do in the long run. Taking the right medicine regularly will prevent outbreaks of abnormal thinking and limit the consequences of having schizophrenia.

Researchers are learning more and more about how the brain works. With this information, better medicines with fewer side effects can be developed so that people with schizophrenia can live without being limited by their illness.