Items Tagged With Schizophrenia

There are many theories about the cause of schizophrenia, but none have been proved.

There is some evidence that genetics may play a role. Your chance of developing schizophrenia is 10 times greater if your parent or sibling has the disease.² But having a relative with schizophrenia does not mean you will get this disease. Many people develop schizophrenia who do not have a relative with this condition.

Schizophrenia may also be related to problems experienced during pregnancy, including malnutrition or exposure to a viral infection, that can damage an unborn child's developing brain and nervous system.² Recent evidence suggests that treating a pregnant woman who has high blood pressure with diuretics during the third trimester may put the baby at risk for later developing schizophrenia.³

Another recent study suggests that a child is at greater risk for developing schizophrenia if the father is over the age of 50 when the child is conceived.⁴ Another possible cause is a head injury in a child who has a parent or sibling with schizophrenia-the head injury may trigger this brain disease if the child is genetically already at risk.⁵

Schizophrenia symptoms also have been linked with the use of illegal drugs.

More research is needed to understand the cause(s) of schizophrenia.

Schizophrenia is diagnosed with a medical history, physical exam, and a mental health assessment.

If a health professional suspects that you may be depressed or considering suicide, a suicide assessment may also be done.

Other tests, such as a CT scan or an MRI, and blood tests may be done to rule out other conditions that can cause symptoms similar to schizophrenia.

New evidence suggests that the structure of the brain may be different in those who develop schizophrenia.⁷ Brain imaging studies (such as a CT scan or an MRI) may be done to evaluate the size, structure, and functioning of the brain.

Schizophrenia is accurately diagnosed when:

• You have at least two of the following symptoms in the active phase of the disorder, each having lasted for at least 1 month:
  • Hallucinations
  • Delusions
  • Disorganized speech
  • Grossly disorganized or catatonic behavior
  • Negative symptoms (no emotion, inability to experience pleasure, difficulty concentrating)
• Problems functioning on the job or with other people.
• Continuous signs of schizophrenia that have been present for at least 6 months, with symptoms being active for at least 1 month.
• Your symptoms are not due to other mental health or substance abuse problems.

Other tests (including blood tests) may be done to help rule out other conditions with similar symptoms or diagnose other schizophrenia spectrum disorders.

Early Detection

There is no routine screening for schizophrenia. If you see a health professional because you have unusual thoughts or feelings, the health professional may first perform a mental health assessment to check for signs of schizophrenia or other conditions, such as dementia.

Medications are the primary treatment for managing the symptoms of schizophrenia; however, they can sometimes have severe side effects, so regular monitoring is needed.

A combination of several medications may be the most effective treatment for schizophrenia. But it may take time to determine which medications will best control your symptoms, and it can be difficult to get through this period. Surrounding yourself with a support system-such as your family or a community-based rehabilitation program-can provide you with the help you need.

Medication Choices

The following medications are used to treat people with schizophrenia:

• First-generation antipsychotics, such as haloperidol (Haldol) or chlorpromazine (Thorazine), which are used to reduce anxiety and agitation, and to stop delusions and hallucinations. These medications can be very effective but often have significant side effects, such as tardive dyskinesia, which is a condition that causes uncontrolled body movements.
• Second-generation antipsychotics, such as risperidone (Risperdal), paliperidone (Invega), olanzapine (Zyprexa), ziprasidone (Geodon), and quetiapine (Seroquel). These medications effectively treat symptoms of schizophrenia and may help reduce the risk for relapse.
  • Clozapine, such as Clozaril or Leponex, is usually considered a second-generation antipsychotic. This drug is approved in the United States for treating suicidal behavior associated with schizophrenia. But in the U.S., your doctor will need special authorization to prescribe clozapine for schizophrenia symptoms, and special monitoring is needed when clozapine is used.

A combination of medications sometimes works best for controlling symptoms of schizophrenia. Other medications that are often used along with antipsychotic medications include:¹²

• Lithium carbonate, such as Lithobid, Lithane, and Eskalith, to regulate moods.
• Antianxiety medications, such as alprazolam (Xanax) and diazepam (for example, Valium), to reduce anxiety and nervousness.
• Anticonvulsant medications, such as carbamazepine (for example, Tegretol) and valproate (for example, Depakote), to reduce symptoms during relapse.
• Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) (for example, Zoloft or Celexa) or tricyclic antidepressants (for example, Pamelor), to reduce symptoms of depression that often occur along with schizophrenia.

What To Think About

Second-generation antipsychotics used to treat schizophrenia are less likely to cause certain side effects than first-generation antipsychotics. Second-generation antipsychotics may also be more effective in preventing relapse than first-generation medications.¹⁰ If you have been taking first-generation antipsychotics (such as haloperidol) and have experienced severe or bothersome side effects, talk with your doctor about whether a second-generation antipsychotic may work better for you.

If you stop taking your medications, you will probably have a relapse. Do not stop taking your medications until you first talk with your health professional about the risks and benefits.

Some side effects of antipsychotic medications (such as low blood pressure or tremors) can be serious.

• How to recognize signs of neuroleptic malignant syndrome. The first signs usually include high fever-between 102 F and 103 F-fast or irregular heartbeat, rapid breathing, and severe sweating.
• How to recognize the first signs of tardive dyskinesia. Some of the first signs may include lip-smacking or continuous chewing; tongue-twitching or thrusting the tongue out of the mouth; or quick, jerky movements (tics) of the head.