What Is Schizophrenia?
Schizophrenia is a psychotic disorder in which affected patients experience a wide range of symptoms, categorized into positive or negative symptoms and cognitive defects (Figure 1).
Although there is much more to be known about schizophrenia, it is believed that one of the causes of the disease is an interference in the development of neurons. This points to Wnt signaling as an important factor. The D2 receptor for dopamine is over activated, which will in turn inhibit Akt, a phosphokinase. This will cause excessive activation of GSK, resulting in a lack of β-catenin, so TCF/LEF transcription (gene transcription important in cell growth and differentiation) will be inhibited.
Effects of Antipsychotic Drugs
Antipsychotic drugs are used to treat patients who are suffering from some type of psychosis. Psychosis is a condition affecting the mind and involves a loss of contact with reality, such as delusions or hallucinations. The general mechanism of antipsychotics is D2 receptor antagonism. These drugs work to reduce the positive and/or negative symptoms (see Figure 1) of schizophrenia, but do not work to cure the disease itself.
One key to effectively treating schizophrenia is finding the right balance between medications (as many patients are also taking anti-depressants and/or anti-anxiety drugs) and possibly also including some type of psychotherapy, such as cognitive therapy, group therapy, or social skills training.
There are two types of antipsychotics: typical (first-generation) and atypical (second-generation). Atypical drugs were introduced due to many of the typical drugs cause debilitating extrapyramidal side effects, such as tardive dyskinesia (TD), parkinsonism, akathisia, and acute dystonias.
As is expected from a drug working to soothe neural problems, the list of side effects given by the FDA is quite long. This list includes:
- Drowsiness
- Dizziness
- Restlessness
- Weight gain
- Dry mouth
- Constipation
- Nausea
- Vomiting
- Blurred vision
- Low blood pressure
- Uncontrollable movements (ex. ticks and tremors)
- Seizures
- Low white blood cell count
- Muscle rigidity
- Persistent muscle spasms
Long-term use of antipsychotics can also result in many serious side effects, one of them being tardive dyskinesia. TD can range from mild to severe, and causes uncontrollable muscle movements, typically around the mouth. TD can be incurable, but some patients can have partial to full recovery after discontinuing their antipsychotic medication.
The Problem With Anti-Psychotic Drug Treatments
Many patients stop taking their anti-psychotic medication after only a short period of time due to these numerous and, in many cases, quite severe side effects. Another drawback to the current medications for schizophrenia is that these drugs do not work on curing the disease. This means that a person suffering from schizophrenia must weigh the many side effects against not a cure for their ailment, but only the hope of attempting to return to a ‘normal’ life.
Due to the many factors that can cause schizophrenia and the limited knowledge of the mechanisms of this disease, it is going to be difficult to move forward in the treatment of schizophrenia, but difficult does not mean impossible.
