Hope for schizophrenics

Schizophrenia is a mental illness which affects one percent of the world’s population. It seriously impairs a person’s ability to think clearly and relate to others. It affects one’s memory, learning and decision-making skills.

Someone with schizophrenia has difficulty distinguishing between what is real and what is imaginary, and is often unresponsive and withdrawn.

Psychiatrists believe that a bio-chemical imbalance in the brain or genetic vulnerability (familial history) may be the underlying causes of schizophrenia, and these could be triggered by environmental and psycho-social factors, such as emotionally distressing conditions.

The good news is people with schizophrenia can lead a more "normal" life with the appropriate medication, therapy and support.

Antipsychotic medications to reduce symptoms of schizophrenia became available in the 1950s. These were generally more effective in controlling positive symptoms (delusions, hallucinations) than negative ones (dulled emotions, passive, quiet, withdrawn).

This first generation of drugs, also known as "typical antipsychotics," often produced unpleasant side-effects, including tardive dyskinesia, a movement disorder affecting the face and extremities. They did not improve memory and fine motor function.

Dr. Gerard Salazar, a fellow of the Philippine Psychiatric Association, cited the need to enhance cognitive functioning of people with schizophrenia to enable them to function normally.

Speaking at the recent "Asian Mind the Mind" forum in Bangkok, Salazar cited the advantages of the new generation or "atypical" antipsychotics.

"These second-generation antipsychotics (SGAs) appear to repair, at least partially, the cognitive dysfunction by improving attention, memory and learning, in addition to improving positive, negative and mood symptoms," Salazar said.

A recent study showed that individuals taking amisulpride, a new generation antipsychotic, have significantly better interpersonal relations skills, verbal fluency, attention and concentration compared to old generation antipsychotics.

Studies have also shown that amisulpride is as effective as other new generation antipsychotics in managing the symptoms of schizophrenia, while enhancing social skills, decision-making ability, and eventually the quality of life of people with the illness.

The SGAs are also better tolerated than first-generation agents, making them an ideal maintenance treatment. "Drug tolerability has a direct impact on patient compliance to a medication which, in turn, is a major factor in preventing relapse," said Salazar.

A number of psychiatrists in the country have been participating in a series of psychiatry fora being held in key Asian cities like Singapore, Macau, Hanoi, Phnom Penh and Bangkok.

The next forum will be held in Shanghai next month. Sleep experts also conduct lectures and discussions on the assessment and management of insomnia in these fora.