ट्रीट -मेंट्स ऑफ़ शिजोफ्रेनिया (ज़ारी...).

First Line of treatment :
Anti -psychotic medicines are tried which can reduce the "positive symptoms "of psychosis in about 7-14 days .
Anti -psychotics however fails to ameliorate the "Negative symptoms" .and cognitive dysfunction.
Costs benefits and risks decides the choice of anti -psychotics.It is a hit and trial ,the benefits are weighed against the side effects .
Two types of anti-psychotic drugs are tried :
(1)Typical or older ones .
(2)Atypical or newer ones .
Both have their pros and cons .,equal drop outs and symptoms relapse rates .
When typicals at low to moderate dosages ,there is a good response in 40-50%,partial in 30-40%,treatment resistance in 20 cases .
Treatment resistance means failure of symptoms to respond satisfactorily after six weeks .Every two in three typicals tried show a resistance to this treatment .

Though CLOZAPINE is an effective treatment for all those who respond poorly to all other drugs ,bur the side effect is Agranulocytosis in 1-4% cases .
Agranulocytosis is lowering of the WBC count (White blood cell counts )reducing resistance to fighting infections (weakening of the immune system ).
side effects of typicals :Higher extra -pyramidal effects .
Pyramidal effects :symptoms caused by a reduction of DOPAMINE activity in the extra -pyramidal system due to the adverse side effects of dopamine receptor antagonists notably Clozapine .
side effects of Atypicals :
weight gain ,diabetes and risk of metabolic syndrome .
on the other end of the spectrum some atypicals (quetiapine ,risperidone ) are associated with a higher risk of death compared to the atypical perphe -nazine ,while CLOZAPINE is associated with a lower risk of death .
It remains unclear whether the newer anti -psychotics(atypicals )reduce the chances of developing the "NEURO -LEPTIC -MALIGNANT -SYNDROME"-a rare but serious neurological disorder .
For those with poor drug compliance and those who are unwilling to take medications long acting Depot preparations of anti -psychotics are used along with psychotherapy .
Depot injection :the administration of a sustained action drug formulation that allows slow release and gradual absorption ,so that the active agent can act for much longer periods than is possible with standard injections .
(cont...)