Schizophrenia (2)

Schizophrenia is probably one of the first disorders to come to mind for many people when asked to identify a psychiatric condition and it is also sadly one of the least understood by the general public.

To many people, a schizophrenic individual is someone who is ‘crazy’ and maybe even thought of as dangerous, violent or as having multiple personalities.

In reality, all of these assumptions about schizophrenia are misinformed. Schizophrenia is a disease of the brain that affects one per cent of the adult population. Although it is very serious and can cause significant disability, most people who suffer from schizophrenia are neither dangerous, violent or experiencing multiple personalities.

Some hallmarks of schizophrenia can include delusions or hallucinations where individuals hear voices or believe someone wants to harm them. Other disturbing symptoms include an altered sense of self, lack of motivation, blunted emotions, depression, social withdrawal and confused communication and thinking.

Symptoms typically begin in early adulthood, between the ages of 15 and 30 and develop gradually as the brain’s ability to process information or communicate with itself deteriorates.

Although the exact cause of schizophrenia is unknown, genetic and physiological factors are known to be involved.

Treatment involves the use of antipsychotic medications and there are several to choose from. Unfortunately, most of the available medications are associated with unpleasant and medically significant side effects such as significant weight gain, increased cholesterol and high blood pressure.

Schizophrenic individuals are at twice the risk of the general population for metabolic syndrome. Metabolic syndrome is characterized by a number of metabolic symptoms occurring in one person – including abdominal obesity, elevated cholesterol and blood pressure, insulin resistance and an elevated inflammatory response in the blood. Although diet and lifestyle do play a role, it is often the necessary psychiatric medication that causes or exacerbates the problem.

These side effects can be quite detrimental to the physical health of the schizophrenic patient and finding the right balance of medication that effectively treats the disorder but doesn’t cause significant side effects is often difficult.

This is why current research is examining the existing medications as well as searching for newer effective antipsychotic drugs that are not associated with weight gain and metabolic syndrome.

One relatively recent study examined several of the most widely used medications and found that patients using olanzapine gained the most weight – an average of two pounds per month. Further, olanzapine and clozapine also appeared to have the highest risk of increased triglyceride and lipid levels, onset of type II diabetes and hyperglycemia.

Risperidone and ziprasidone seemed to have less weight gain associated with their use.

While this information is useful to know, applying it in a practical sense is not as straight forward as it may seem. Not everyone will be able to use the drugs associated with fewer side effects and for some, the only effective drugs to date are the ones that carry higher risks for weight gain and other adverse effects.

What ensues is a clinical dilemma for psychiatrists and their patients – how to best treat the disorder while also maintaining the physical health of the patient.

This is why we are still in search of new medications. The goal is to develop meds that will be free of dangerous side effects and will also effectively treat the disorder’s primary symptoms and allow patients to lead normal, independent lives.

Okanagan Clinical Trials will soon be starting a study of an investigative medication in the treatment of schizophrenia that may not be associated with these side effects of weight gain and metabolic disorder. If you or a loved one are an adult with schizophrenia and would like more information, contact our office at 862-8141.

 

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