Overview: Innovations
in the Pharmacological Management of Schizophrenia
Vernon M. Neppe and Tim Holden
The conventional anti-psychotic drugs (the neuroleptics)
remain a mainstay of the pharmacotherapy of schizophrenia.
In this context, special issues are addressed, such
as conceptual frameworks, the role of sedation, dose-response
relationships, prediction of anti-psychotic responsiveness,
maintenance treatments, long-acting neuroleptics, targeted
management and the biopsychosocial model. In the past
decade the therapeutic potential in schizophrenia of
various drugs used primarily in the treatment of other
conditions, has been systematically assessed. The effects
of this group of ``experimental'' agents in schizophrenia
cannot be solely explained by the dopamine hypothesis,
which is the currently accepted model for the conventional
anti-psychotic drugs. The major members of this experimental
group are lithium, tricyclic antidepressants, beta blockers,
benzodiazepines, clonidine, carbamazepine, the opioids
and electro-convulsive therapy. Whilst many of these
agents have been shown to produce significant improvements
in small but undefined schizophrenic subgroups, there
are no indications that they will replace conventional
neuroleptics as the first line pharmacological treatment
of schizophrenia.
Keywords
Anti-depressants, Anti-psychotic drugs, Benzodiazepines,
Beta blockers, Carbamazepine Clonidine, Depot neuroleptics,
Lithium, Neuroleptic, Novel antipsychotics, Neuropeptides,
Opioids, Schizophrenia
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