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Schizophrenia - Other Treatments

Description

An in-depth report on the causes, diagnosis, and treatment of schizophrenia

Other Treatments:

Electroconvulsive therapy (ECT), often called shock treatment, has received bad press since it was introduced in the 1940s. However, refined techniques have revived its use, particularly for those with severe depression. Imaging studies have not found that current ECT techniques cause any damage to the brain's structure, and some doctors feel it is safer than drug therapy. A recent review of many clinical trials indicated that ECT combined with antipsychotic medication can provide rapid improvements for patients who are suicidal or severely psychotic. The review found that the combined treatment worked better than antipsychotics alone for these patients. ECT treatments are usually given 2 - 3 times a week, for a total of 8 - 12 sessions.

Transcranial Magnetic Stimulation

Investigators are testing a procedure called slow repetitive transcranial magnetic stimulation (rTMS), which affects brain activity in the cerebral cortex. The procedure uses an electromagnet placed on the scalp to administer magnetic stimulation to the brain� ' s cerebral cortex. This region of the brain appears to be associated with auditory hallucinations. A review of 15 clinical trials indicated that rTMS may be an effective treatment for auditory hallucinations. Further research is underway.

Resources

www.nimh.nih.gov -- National Institute of Mental Health
www.mentalhealth.samhsa.gov -- National Mental Health Information Center
www.nami.org -- National Alliance on Mental Illness
www.nmha.org -- Mental Health America
www.narsad.org -- National Alliance for Research on Schizophrenia and Depression
www.psych.org -- American Psychiatric Association
www.aacap.org -- American Academy of Child and Adolescent Psychiatry
www.world-schizophrenia.org -- World Fellowship for Schizophrenia and Allied Disorders
www.schizophrenia.com -- Information resources and research news

References

Aleman A, Sommer IE, Kahn RS. Efficacy of slow repetitive transcranial magnetic stimulation in the treatment of resistant auditory hallucinations in schizophrenia: a meta-analysis. J Clin Psychiatry. 2007 Mar;68(3):416-21.

Bhattacharjee J, El-Sayeh HG. Aripiprazole versus typicals for schizophrenia. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD006617.

Kahn RS, Fleischhacker WW, Boter H, Davidson M, Vergouwe Y, Keet IP, et al. Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet. 2008 Mar 29;371(9618):1085-97.

Leucht C, Kitzmantel M, Chua L, Kane J, Leucht S. Haloperidol versus chlorpromazine for schizophrenia. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD004278.

Lieberman JA. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia: efficacy, safety and cost outcomes of CATIE and other trials. J Clin Psychiatry. 2007 Feb;68(2):e04.

Marder SR, West B, Lau GS, et al. Aripiprazole effects in patients with acute schizophrenia experiencing higher or lower agitation: a post hoc analysis of 4 randomized, placebo-controlled clinical trials. J Clin Psychiatry. 2007 May;68(5):662-8.

Mathews M, Muzina DJ. Atypical antipsychotics: new drugs, new challenges. Cleve Clin J Med. 2007 Aug;74(8):597-606.

McEvoy JP, Lieberman JA, Perkins DO, et al. Efficacy and tolerability of olanzapine, quetiapine, and risperidone in the treatment of early psychosis: a randomized, double-blind 52-week comparison. Am J Psychiatry. 2007 Jul;164(7):1050-60.

Morrens M, Hulstijn W, Sabbe B. Psychomotor slowing in schizophrenia. Schizophr Bull. 2007 Jul;33(4):1038-53. Epub 2006 Nov 8.

Newcomer JW. Metabolic considerations in the use of antipsychotic medications: a review of recent evidence. J Clin Psychiatry. 2007;68 Suppl 1:20-7.

Nussbaum A, Stroup TS. Paliperidone for schizophrenia. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD006369.

Schultz SH, North SW, Shields CG. Schizophrenia: a review. Am Fam Physician. 2007 Jun 15;75(12):1821-9.

Sikich L, Frazier JA, McClellan J, Findling RL, Vitiello B, Ritz L, et al. Double-blind comparison of first- and second-generation antipsychotics in early-onset schizophrenia and schizo-affective disorder: findings from the treatment of early-onset schizophrenia spectrum disorders (TEOSS) study. Am J Psychiatry. 2008 Nov;165(11):1420-31. Epub 2008 Sep 15.

Swartz MS, Perkins DO, Stroup TS, et al. Effects of antipsychotic medications on psychosocial functioning in patients with chronic schizophrenia: findings from the NIMH CATIE study. Am J Psychiatry. 2007 Mar;164(3):428-36.

Torrey EF, Bartko JJ, Lun ZR, Yolken RH. Antibodies to Toxoplasma gondii in patients with schizophrenia: a meta-analysis. Schizophr Bull. 2007 May;33(3):729-36. Epub 2006 Nov 3.

Reviewed last on: 1/22/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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