Monday, July 21, 2008

Schitzophrenia cure? Maybe.....

Well, "cure" may be a bit of a stretch, but we may be on the brink of a new way of treating the disease that may slow, or possibly even stop the progression, and that is certainly welcome news.

I was reading this post over at Life at the Harris County Criminal Justice Center blog about how AHCL's former friend sought him out to seek help for what would appear to be a case of schizophrenia. I have some encouraging news for AHCL and others dealing with schizophrenia: There may be a new theory of disease progression that may lead to, if not a cure, at least better management of a chronic disease.

There is a new treatment regimen that is slowly beginning to take hold in the world of mental illness treatment. Historically people with schizophrenia were thought of as treatable at any time, and if there is interruption or delay of treatment, that the disease progression was unaffected. It was thought that these people were doomed from birth and no amount of treatment would be able to affect the final outcome. That is no longer thought to be the case.

There is mounting evidence that early and aggressive treatment with antipsychotics, even before true psychosis sets in, can dramatically alter the disease progression. During a psychotic break, the parts of the brain involved with rational thought become quiescent. The more often and the longer that these psychotic breaks persist, the harder it is for the rational parts to function again. In fact, those parts of the brain begin to atrophy and waste away. When that begins to happen, full recovery is probably impossible.

Additionally it has long been known that drugs that affect the production and transport of dopamine were the best treatments available for schizophrenia. These antipsychotics however had a whole host of unpleasant side effects, including tremors, uncontrollable involuntary movements (tics) , weight gain, impotence/anorgasmia, and short term memory, among others. but a new drug developed by Eli Lilly which is curently in phase II trials is thought to be a better approach. It was discovered by accident several years ago that people who are on PCP experience many of the same symptoms that Schizophrenics do. PCP affects the action of glutimate, which is known to modulate how dopamine works in the brain. Eli Lilly found a drug that instead of being a dopamine antagonist, is a glutimate antagonist. This drug is thought to have fewer side effects than the D2 (dopamine receptor) antagonists.

We may be entering a new era in schizophrenia treatment. Can we expect a cure? Way too early to say, but probably not anytime soon, but we may be able to pull a number of young people back away from the brink and help them to lead productive lives for much longer that they would have been able to, only a few years ago.

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