What does schizophrenia teach us about antipsychotics?

Abstract

OBJECTIVE:

To examine how advances in our understanding of schizophrenia have shaped thinking about antipsychotics (APs) and their role in treatment.

METHOD:

Three specific developments in the field of schizophrenia are highlighted: advances in knowledge related to the earliest stages of schizophrenia, specifically the prodrome; reconceptualization of schizophrenia as an illness of multiple symptom domains; and greater clarification regarding the efficacy of clozapine and a new generation of APs.

RESULTS:

Evidence indicating that negative and cognitive symptoms are present during the prodrome suggests that intervention at the time of first-episode psychosis constitutes late intervention. The limited efficacy of APs beyond psychosis argues against a magic bullet approach to schizophrenia and for polypharmacy that is symptom domain-specific. Clozapine's unique, but limited, efficacy in treatment resistance supports subtyping schizophrenia based on treatment response.

CONCLUSIONS:

Advances in our understanding of schizophrenia have important implications regarding the current use of APs, expectations regarding response, and future drug development.

• Authors: Gary Remington, Ofer Agid, George Foussias, Gagan Fervaha, Hiroyoshi Takeuchi, Jimmy Lee, Margaret Hahn
• Journal: Canadian journal of psychiatry. Revue canadienne de psychiatrie (Can J Psychiatry) Vol. 60 Issue 3 Suppl 2 Pg. S14-8 (Mar 2015) ISSN: 1497-0015 [Electronic] United States
• PMID: 25886675 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antipsychotic Agents

Topics

• Antipsychotic Agents (therapeutic use)
• Humans
• Prodromal Symptoms
• Schizophrenia (drug therapy, physiopathology)
• Treatment Outcome