Fast Five Quiz: What Do You Know About Schizophrenia?

Stephen Soreff, MD

Disclosures

August 09, 2019

Antipsychotic medications are a mainstay of treatment, together with psychological and psychosocial inputs. These medications diminish the positive symptoms of schizophrenia and prevent relapses. If they are stopped, about 80% of patients relapse within 1 year; only 20% relapse if treated.

However, patients tend not to be adherent to antipsychotic medications due to their serious side effects, which include akathisia, dystonia, hyperprolactinemia, neuroleptic malignant syndrome, parkinsonism, and tardive dyskinesia. These cited side-effects contribute to patients’ noncompliance with their medications. In general, second-generation antipsychotic medications (eg, clozapine) produce these adverse effects less frequently than first-generation antipsychotics (eg, chlorpromazine). Most, but not all, antipsychotic medications produce anticholinergic effects, and some create QT interval prolongation. Weight gain is a frequent side effect, associated with altered glucose and lipid metabolism. The frequency of weight gain as a side effect is an important reason to promote exercise programs for patients on antipsychotic medication. This weight gain as well as an associated immune dysfunction may contribute to patients with schizophrenia having a less than full life expectancy.

To learn more about pharmacotherapy for schizophrenia, read here.

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