J u l y 2 0 1 3
“There is no way to predict who will do best onMedication UPDATE
This fact sheet discusses schizophrenia medications and the pros
they are now considered by most clinicians as essential first-line
and cons of changing from an older antipsychotic medication to
treatment for newly-diagnosed patients.
one of the newer “atypical” ones. As always, a note of caution:
This is not the last word on the subject. Nothing can replace
talking to a doctor about medications for a specific individual. Clozapine has been acclaimed because about one-third of patients with treatment-resistant schizophrenia who have not “STANDARD” ANTIPSYCHOTICS responded to other medications show at least some
It’s a good idea to learn some of the technical medication “lingo”
improvement on clozapine. It is also recommended for people
that mental health professionals use. Until recently, doctors have
who are showing signs of tardive dyskinesia, since it rarely causes
called antipsychotic medications neuroleptics because of their
tendency to cause neurological side effects. Medications that
The major drawback of clozapine is the slight risk (1%) that it will
have been around for a few years are now called “standard”
cause white blood cells to decrease, subsequently decreasing the
antipsychotics. Examples of standard antipsychotics include
person’s resistance to infection. Therefore, people taking
Thorazine, Modecate, Proloxin, Navane, Stelazine and Haldol.
clozapine must have their blood count monitored regularly.
Trying to understand the bewildering array of medications can be
frustrating. A user-friendly reference book, such as Fuller Torrey’s
REASONS FOR SWITCHING MEDICATION Surviving Schizophrenia, is helpful in this regard.
The most common reasons for switching from a standard
antipsychotic to an atypical antipsychotic are:
SIDE EFFECTS (EPS)
Persistent positive symptoms (hallucinations, delusions, etc.)
Side effects can be a major problem with standard antipsychotic
medications. These neurological side effects are called
Persistent negative symptoms (blunted emotions, social
“extrapyramidal side effects” (EPS for short) because of the area
withdrawal, etc.) despite taking medication
of the brain where the drugs cause the side effects. Specific
Severe discomfort from side effects and little or no relief from
examples of EPS include akinesia (slowed movement), akathisia
(restless limbs), and tardive dyskinesia.
Severe and persistent tardive dyskinesia
In most cases, switching medications can be done at any time. “ATYPICAL” ANTIPSYCHOTICS
The newer antipsychotic drugs are called atypical antipsychotics.
The person who is ill should take lots of time to think about it and
Atypical medications are now used more frequently. They are
talk it over with family, friends, and the treatment team. People
should also be aware that atypical antipsychotics may have side
They do not have the same chemical profiles as standard
effects of their own, such as weight gain and sexual problems.
It’s true that the newer medications tend to produce less side
They seem to work in a different way than standard
effects—but they may still cause some. People taking atypical
antipsychotics must continue to be monitored for neurological
They appear to cause fewer EPS than standard medications.
“There are many new and exciting treatments for psychotic
If someone is considering switching from a standard to an
symptoms. Atypical antipsychotics offer consumers choices they
atypical antipsychotic, please remember—this article is only a
didn’t have even a few years ago. However, new choices also
general discussion of some of the issues. Hopefully, having a few
present new challenges.to get the most out of the new
guidelines will help you begin to ask the right questions.
medications with the least risk possible.” - Peter Weiden, MD
At the moment, there are several atypical antipsychotics
-Adapted from a consumer handout by Dr. Peter Weiden, St. Luke’s-Roosevelt
available in Canada—risperidone, clozapine, olanzapine, and
quetiapine, ziprasidone, aripiprazole, asenapine, lurasidone. NEWER MEDICATIONS: Risperdal* Consta* (risperidone);
Zyprexa* (olanzapine); Seroquel* (quetiapine); Geodon* or
Zeldox* (ziprasidone); Abilify* (aripiprazole); Invega
(paliperidone); *Saphris (asenapine); Latuda*(lurasidone)
Results to date from the above atypical antipsychotic
British Columbia Schizophrenia Society
medications are encouraging. While not effective for everyone,
Für den an unserer wissenschaftlichen Arbeit interessierten Leser finden Sie im Folgenden eine Auswahl unserer 2000 – 2003 publizierten Vorträge und Kongress-Beiträgen: 1. Carlsson J. Schulte B. Erdogan A. Sperzel J. Guttler N. Schwarz T. Pitschner HF. Neuzner J. (2003) Prospective randomized comparison of two defibrillation safety margins in unipolar, active pectoral defibrillator therapy.
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