2. Triple Whammy—HIV, Mental Disorders, African Americans
How is schizophrenia treated?
Because the causes of schizophrenia remain unclear, treatments focus on controlling the symptoms of the disease and primarily consist
of antipsychotic medications and psychosocial treatments.
Antipsychotic Medications
Antipsychotic medications developed in the
mid-1950s are known as "typical" antipsychotics and include:
- Chlorpromazine
- Haloperidol
- Perphenazine
- Fluphenazine
More recently developed antipsychotic medications are called "atypical" antipsychotics. The first one listed is associated with risk of agranulocytosis, but the others are not. These drugs include:
- Clozapine
- Risperidone
- Olanzapine
- Quetiapine
- Ziprasidone
- Aripiprazole
- Paliperidone
On a clinician’s advice, discontinuation of these medications should be done gradually, never suddenly.
Adverse events associated with antipsychotics
Although all antipsychotic medications are associated with risk of various adverse events—drowsiness, rash, tachycardia, and others—these generally diminish or cease with continued use. Long-term use of typical antipsychotics, however, may be associated with development of tardive dyskinesia, and clinicians should monitor its use closely. Atypical antipsychotic medications may be associated with major weight gain and metabolic changes, with increased risk for diabetes and elevated cholesterol level. [Lieberman 2005] Therefore, patients’ relevant laboratory parameters should be monitored regularly.
Antipsychotics can also interact adversely when taken with certain medications, dietary supplements, and alcohol. Therefore, clinicians should discuss all coadministered drugs and supplements with patients to minimize risk of interactions.
