Drug treatments for schizophrenia.

Abstract

This paper summarises the research evidence presented in a recent issue of Effective Health Care on drug treatments for schizophrenia.1 Schizophrenia is an illness or a group of illnesses affecting language, planning, emotion, perceptions, and movement. In the UK, approximately 250 000 people suffer from schizophrenia or a schizophrenia-like illness.2 A quarter of those who have experienced an episode of schizophrenia recover and the illness does not recur. Another 25% experience an unremitting illness. The remaining 50% have a recurrent illness, but with long episodes of considerable recovery from positive symptoms such as delusions, hallucinations, disordered thinking, and catatonic movements.3 Many with recurrent illness have enduring problems from schizophrenia such as persistent psychotic symptoms, but, for most people, the problems consist of negative symptoms such as loss of enthusiasm and emotional responsiveness, apathy, and social withdrawal.3 These negative symptoms, though intrinsic to schizophrenia, are compounded by the adverse effects of drugs, living in impoverished circumstances, and by the social stigma associated with mental illness. Recovery from episodes of schizophrenia for some people is often complicated by episodes of depression, substance abuse, and anxiety. People with schizophrenia have a shortened life expectancy4 due to physical illness, accidents, and other causes of violent death, especially suicide.5 Treatments for schizophrenia are divided into the so-called “physical interventions” of drugs, psychological and social managements and, rarely in the UK, electroconvulsant treatment. This article draws upon evidence from systematic reviews undertaken by the Cochrane Schizophrenia Group, and summarises the evidence on the effectiveness of the main drugs used in the treatment of schizophrenia. More detailed information is available on each treatment within the referenced reviews. These reviews are regularly updated in the Cochrane Library .6 The main class of drugs used to treat or manage schizophrenia is antipsychotics …