Schizophrenia is considered the most serious of all psychiatric disorders. The symptoms, which include hallucinations, delusions, and grossly disorganized or catatonic behavior can render a person significantly disabled until or unless stabilized. Sadly, there is currently no cure for this challenging and complex disorder. It is considered a life long disorder, so the symptoms typically reappear throughout one’s lifetime if not treated, and in many cases even if treated.
Over the years, various drugs have been developed for the treatment of schizophrenia. While they all come with many side effects, it is often a matter of choosing the lesser of two evils – coping with and managing side effects or not being able to function at all on a fairly regular basis due to severe symptoms. For many, taking medication is the preferred option. It helps control symptoms and minimize their recurrence.
First generation antipsychotics
Back in the early 1950s, one of the first drugs used to treat schizophrenia was introduced to the U.S. market. This drug, Thorazine, was the first in a long line of medications often referred to as first generation antipsychotics. They are also called conventional antipsychotics, major tranquilizers, or typical antipsychotics. Haldol, Trilafon, and Mellaril are a few of the medications in this group.
These medications allowed individuals with schizophrenia to have more normal lives, and function better in society. Unfortunately, because of multiple problematic side effects, not to mention the very nature of the disorder, many schizophrenics didn’t (and still don’t) stay on their medication. Two side effects in particular which are closely associated with the typical antipsychotics are tardive dyskinesia (TD) and neuroleptic malignant syndrome (NMS).
TD is often permanent and causes involuntary, uncontrollable and random movements of the face and body. NMS can be fatal, and includes symptoms like muscle stiffness, difficulty breathing, altered mental status, sudden renal failure, fluctuations in blood pressure or heartbeat, tremors, dehydration, racing heartbeat, and very high fever.
Atypical antipsychotics
Since the early 1990s, a second group of medications, referred to as atypical antipsychotics or second generation antipsychotics (or “third generation antipsychotics” for the most recent), started to become available. These medications were initially well received because there was less risk of some of the problematic side effects of the older medications, particularly TD and NMS.
Medications which fall into this group include Zyprexa, Seroquel, Risperdal and Abilify, to name a few. The newest atypical antipsychotic to be FDA-approved for schizophrenia is Asenapine (brand name Saphris). It was FDA-approved in late 2009 1. The atypical antipsychotics still come with many side effects, and just as with the older medications, many people with schizophrenia discontinue them as a result.
Until a cure is found for schizophrenia, if that ever happens, drugs will likely be one of the core treatments for this disorder. Research is ongoing to find ways to better treat schizophrenia.
written by Dr. Cheryl Lane, PsyD
Links to Additional Schizophrenia Drug Articles
References
- Asenapine for Schizophrenia and Bipolar I Disorder
