On the treatment of schizophrenia with drugs was Re: Movies and madness

Gary MacLennan g.maclennan at qut.edu.au
Tue Apr 30 15:22:33 MDT 2002

At 01:48  30/04/02 -0400, Lou wrote:
>Such inner voices are one of the main
>characteristics of schizophrenia. Medication serves to quiet them, but at
>the expense of one's overall energy and receptiveness. Since schizophrenics
>find communication difficult to begin with, it is understandable why they
>would shun medication.


thank you for this grand tour of film and mental illness.  Now I
specifically snipped the above to point out that we need to know a lot more
about medication.  This is generally divided into generations.  Beginning
in the 50s we had the first drugs - discovered by the way in trials on
French soldiers who had fought in Vietnam.  These drugs are still in
use.  They are in fact the first line of drugs used as their impact can be
very dramatic. They do not work however on about 25% of sufferers and they
also have terrible side effects.

Starting in the 70s a new drug was discovered - Clozaril.  This marked the
beginning of the second generation drugs.  Clozaril itself unfortunately
caused a serious illness of the blood in about 1% of cases. After some
patients died it was withdrawn from the market. However the chemists and
their companies got to work to produce Clozaril like drugs and there are
now four of these approved by the FDA. Clozaril too has been reissued with
strict new guidelines, including regular blood checks.

These new drugs mark a qualitative leap forward in the treatment of those
who struggle with schizophrenia. They, especially Clozaril, have a wider
range of efficacy than traditional drugs. There continue to be problems of
course.  The side effects are much less severe but they can still manifest
themselves.  Olanzapine (Zyprexa) for instance can lead to shocking obesity.

There is now talk of a third generation of drugs.  Otsuka have produced a
new drug -Aripiprazole- which they claim is different in effect from the
Second Generation.  There are also reports of experimental drugs in trial
in Sweden and elsewhere.  It remains to be seen whether these claims are
true or whether they constitute market driven hype.

But overall the outlook for people with schizophrenia has never been
brighter.  That of course is not to deny that it is still a grim situation.
However there is hope and that what we should focus our minds on.

Re your remarks about capitalism and mental illness I could not agree
more.  We should also note that there is a clearly established correlation
between the incidence of schizophrenia and poverty.



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