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The Use of Medication in Treating Schizophrenia - Page 2


© Ian Chovil
Page 2

The side effect profile of each drug I've mentioned is different from the other and variable with each individual. Risperidone causes prolactin level elevation which has some undesirable long term side effects and can cause problems with menstruation and other related sexual side effects. Olanzapine sometimes causes weight gain. I gain 10 lb. for every 5 mg. I take and I wouldn't be willing to take more than the 10 mg I take now. Seroquel is virtually free of any side effects but for reasons I don't understand it hasn't become as popular as I would have expected. Clozapine causes even more weight gain than Olanzapine but even with the fortnightly bloodwork people taking Clozapine are generally very compliant. They like the way they feel on Clozapine.

Five years ago the most commonly prescribed antipsychotic was Haldol, a conventional antipsychotic. It was the one everybody hated to take. The side effect profile of the twenty or so conventionals was brutal, and the biggest reason for noncompliance. It didn't help that psychiatrists were prescribing much higher doses than was actually required. Someone prescribed 20 mg of Haldol daily might have had the same control of symptoms at 5 mg.

Half of the people diagnosed with schizophrenia are still taking a conventional antipsychotic according to one of my local drug reps. A percentage of those would be a on depot medications, like Modecate, Fluanxol or Haldol. A depot medication is an injection you receive every two to three weeks that guarantees the individual is receiving medication over that time period. It is often utilized when compliance is an issue and the individual is having difficulty with daily medication. A depot form of Risperidone is being tested but at the moment there is no depot form for any atypical.

Once a diagnosis of schizophrenia has been made the individual can generally expect to be taking an antipsychotic for the rest of their life. It becomes important that the individual is comfortable with the medication and the dosage they are taking. That is so much more possible with the atypical medications because of their low side effect profile. It is also quite likely that anyone taking an atypical antipsychotic now, will be switched to a newer one within five years or so because there are fifteen newer drugs under development and testing now. Some of those drugs promise to be more effective with even fewer side effects than anything available now. Who knows what will be available in ten years.

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