by Galen Gregory

Created on: March 11, 2009

Schizophrenia is a severe brain disorder which affects one percent of people in the United States. It is a chronic condition with a typical onset in the late teens or 20s for men and in the 20s to 30s for women. It is thought to result from a chemical imbalance of the neurotransmitters dopamine and glutamate in the brain.

The symptoms of schizophrenia fall into three categories: positive symptoms, negative symptoms, and cognitive symptoms. The positive symptoms are the ones with which the general public is most familiar, thanks to characterizations in the media. They include auditory and visual hallucinations, delusions, and unusual thought processes. Most people are less aware of the negative symptoms, which include lack of motivation, flat affect, decreased social interaction, and an inability to enjoy life. These negative symptoms can have a significant impact on the person's ability to function on even a basic level, resulting in neglect of hygiene and other activities of daily living. Cognitive symptoms result in decreased mental abilities in the areas of executive function, memory, and attention. These deficits interfere with the person's ability to get an education, hold down a job, and live independently.

The primary treatment of the disorder is antipsychotic medication. First generation antipsychotic medications were developed in the 1950s; these include medications such as Haldol, Thorazine, Prolixin, and Trilafon. While these medications are often effective in controlling positive symptoms, they are generally considered less effective in countering the negative symptoms. They also can have serious side effects, such as causing tardive dyskinesia, an irreversible motor disorder. A new generation of antipsychotic medications, commonly referred to as atypical antipsychotics, was developed in the 1990s; these medications include Risperdol, Zyprexa, Seroquel, and Geodon. These medications are effective in reducing positive symptoms and somewhat effective in treating the negative symptoms. They do not have the extrapyramidal side effects of first generation antipsychotics, but have their own set of serious side effects, namely the possibility of triggering metabolic syndrome, which causes weight gain, diabetes, and cardiovascular problems. The original atypical antipsychotic drug, Clozapine, is considered to be both the drug of last resort and the "gold standard" of antipsychotics, as it is often effective when a patient has not responded to the other medications.

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