Complications of Schizophrenia
Schizophrenia can have a devastating impact on patients and their families. Patients with schizophrenia have increased risk for self-destructive behaviors and suicide. The antipsychotic drugs used to treat schizophrenia can have severe side effects, including increased risk of obesity and diabetes.
Schizophrenia is a chronic condition, which is usually treated with antipsychotic medication. There are two main classes of these drugs:
- Typical antipsychotics (“first-generation” antipsychotics) include haloperidol (Haldol), chlorpromazine (Thorazine), perphenazine (Trilafon), thioridazine (Mellaril), mesoridazine (Serentil), trifluoperazine (Stelazine), and fluphenazine (Prolixin). All of these drugs are available as generics.
- Atypical antipsychotics (“second-generation” antipsychotics) include clozapine (Clozaril, generic), risperidone (Risperdal, generic), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify),palperidone (Invega), and lurasidone (Latuda).
- In 2010, the FDA approved a new atypical antipsychotic, lurasidone (Latuda) for treating schizophrenia in adults.
- In 2009, the FDA approved the atypical antipsychotics olanzapine (Zyprexa) and quetapine (Seroquel) for treatment of schizophrenia in adolescents ages 13 - 17 years. The FDA cautions that olanzapine is associated with increased weight gain and unhealthy cholesterol levels and may not be the best first-line drug choice for adolescent patients.
New Recommendations for Schizophrenia Treatment
In 2009, the Patient Outcomes Research Team (PORT) presented updated evidence-based treatment guidelines at the International Congress on Schizophrenia Research. The recommendations included:
- For drug treatment, first-line choices include both typical atypical and atypical antipsychotics, with the exception of clozapine and olanzapine (due to their adverse effects on obesity, insulin resistance,and cholesterol levels). However, clozapine may have specific benefits for treating violent, hostile, and suicidal behavior symptoms.
- For psychosocial therapies, schizophrenia treatment should also address alcohol and substance abuse, smoking cessation, and weight management.