schizophrenia
SCHIZOPHRENIA
Schizophrenia is a devastating mental illness characterized by symptoms eg hallucinations, disorganized thinking, loss of goal-directed behaviors and deterioration in social role functioning.
Positive or psychotic symptoms are delusions, hallucinations, and distorted perceptions.
Negative symptoms include flat or blunted emotions, lack of motivation or energy, lack of pleasure or interest in things, and limited speech.
Disorganized symptoms are confused thinking, disorganized speech and behavior.
Cognitive symptoms include impairment in attention verbal fluency memory, and executive functioning.

Supportive Therapy

Pharmacological Therapy for Adverse Reactions to Antipsychotics

Adjunctive Medications

  • It may be necessary to use additional medications along with antipsychotics
    • Adjuncts (eg anticholinergic agents) may be used to treat side effects caused by antipsychotics
    • Other adjuncts may be used to treat refractory psychotic symptoms, comorbidities or nonpsychotic symptoms eg agitation, anxiety and depression
Anticholinergic Agents
  • Effect: Effectively treat extrapyramidal symptoms due to antipsychotics
    • May be added to atypical antipsychotics to treat akathisia, extrapyramidal symptoms or excessive salivation due to Clozapine
Mood Stabilizers
  • Lithium
    • Used to stabilize mood and reduce excitement in patients treated with antipsychotics
    • Effect: Has been shown to augment the antipsychotic response when added to conventional antipsychotic medications
  • Valproate and Carbamazepine
    • Effects: Stabilize mood and help reduce persistent agitation in schizophrenia
Benzodiazepines
  • Effects tend to be most useful in the acute management phase
  • Effects: Treat agitation, insomnia, anxiety, akathisia and other concomitants of schizophrenia
Beta-Blockers
  • Effect: Treat akathisia due to conventional antipsychotics
Antidepressants
  • Depressive symptoms are usually treated after acute psychosis has been treated with antipsychotics
    • Use antidepressants with caution in the acute phase of illness since they may exacerbate psychotic symptoms
  •  Effect: Effectively treat residual (post-psychotic) depressive symptoms
Bupropion
  • It has been shown to be effective in people with schizophrenia who also smoke tobacco, particularly when combined with nicotine replacement therapy
  • Should be offered to schizophrenia patients who want to reduce or quit smoking
  • May lower epileptic threshold
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