Schizophrenia is a brain disorder that affects approximately two million Americans today. Schizophrenia can affect anyone at any age, but most cases develop between adolescence and age 30. Children can be affected by schizophrenia, but this is uncommon.
Schizophrenia impairs a person's ability to think clearly, manage his or her emotions, make decisions, and relate to others.
The symptoms of schizophrenia are generally divided into three categories, including positive, disorganized and negative symptoms.
Positive Symptoms, or "psychotic" symptoms, include delusions and hallucinations because the patient has lost touch with reality in certain important ways. "Positive" as used here does not mean "good." Rather, it refers to having overt symptoms that should not be there. Delusions cause the patient to believe that people are reading their thoughts or plotting against them, that others are secretly monitoring and threatening them, or that they can control other people's minds. Hallucinations cause people to hear or see things that are not there.
Disorganized Symptoms include confused thinking and speech, and behavior that does not make sense. For example, people with schizophrenia sometimes have trouble communicating in coherent sentences or carry on conversations; move more slowly, repeat rhythmic gestures or make ritualistic movements such as walking in circles; and have a hard time making sense of everyday sights, sounds and feelings.
Negative Symptoms include emotional flatness or lack of expression, an inability to start and follow through with activities, speech that is brief and lacks content, and a lack of pleasure or interest in life. "Negative" does not, therefore, refer to a person's attitude, but to a lack of certain characteristics that should be there.
To be diagnosed with schizophrenia, a patient must have psychotic, "loss-of-reality" symptoms for at least six months and show increasing difficulty in functioning normally.
Although the cause of schizophrenia has not yet been identified, recent research suggests that schizophrenia involves problems with brain chemistry and brain structure. Scientists are currently investigating viral infections, mild brain damage from complications during birth, and genetic predisposition as possible factors.
While there is no cure for schizophrenia, it is a highly treatable disease. In fact, the treatment success rate for schizophrenia is 60 percent, compared with 41-52 percent for heart patients.
Antipsychotic drugs are used in the treatment of schizophrenia. These medications help relieve the delusions, hallucinations, and thinking problems associated with this devastating disorder. These drugs appear to work by correcting an imbalance in the chemicals that help brain cells communicate with each other. As with drug treatments for other physical illnesses, many patients with severe mental illnesses may need trials of several different antipsychotic medications before they find the one, or the combination of medications, that work best for them.
Conventional or Standard Antipsychotics include: chlorpromazine (Thorazine); fluphenazine (Prolixin); haloperidol (Haldol); thiothixene (Navane); trifluoperazine (Stelazine); perphenazine (Trilafon) and thioridazine (Mellaril).
Atypical Antipsychotics are newer drugs with fewer side effects and include: risperidone (Risperdal); clozapine (Clozaril); olanzapine (Zyprexa) and sertindole (Serlect).
Because people with schizophrenia must take their medications for many years, usually for their whole life, many may experience varying side effects. As a group, antipsychotic drugs are safe, and serious side effects are relatively rare. Some people may experience side effects that are inconvenient or unpleasant, but not serious.
Most common side effects: dry mouth, constipation, blurred vision, and drowsiness.
Less common side effects: decreased sexual desire, menstrual changes, stiff muscles on one side of the neck and jaw.
More serious side effects: restlessness, muscle stiffness, slurred speech, tremors of the hands or feet, and a deficiency of a type of white blood cell (when taking clozapine) that requires monitoring.
Tardive Dyskinesia is the most unpleasant and serious side effect of antipsychotic drugs causing involuntary facial movements and sometimes jerking or twisting movements of other parts of the body. This condition usually develops in older patients, affecting 15 to 20 percent of those who have taken older antipsychotic drugs for years.
Despite media focus on the exceptions, individuals receiving treatment for schizophrenia are no more prone to violence than the general public. Unfortunately, almost one-third of all U.S. jails incarcerate people with severe mental illnesses who have no charges against them, but are merely waiting for psychiatric evaluation or the availability of a psychiatric hospital bed.
