Schizophrenia remedies work with side effects

Schizophrenia: Metastudy shows lower psychotic relapse rate

03/05/2012

Medication in schizophrenia has strong side effects, which is why psychiatrists do not always prescribe the remedies for relapse prevention. A new meta-study examined the relapse rate with and without medication. The results showed that the funds appear to be able to prevent relapses. However, meta-analysis was only able to study a study timeframe of two years. Research on long-term effects is still missing.

Massive side effects of antipsychotics
If a patient suffers from an acute psychosis, every specialist in psychiatry, despite side effects will use medication to relieve the delusional symptoms. In modern psychiatry special antipsychotics are therefore administered to treat the most severe mental illness so far. The order easily falls to psychiatrists at the moment of impending psychosis. But if a relapse should be avoided, due to the sometimes serious side effects is not always a drug administered to the person concerned.

Depending on the drug, atypical antipsychotics may cause significant weight gain. In some drugs, the formation of the so-called metabolic syndrome was observed. The syndrome is characterized by obesity, high blood lipid levels and a significantly enlarged waist circumference. A metabolic syndrome can lead to complications such as diabetes, stroke or heart attack. In the older, conventional antipsychotics it is not uncommon for movement disorders. Those affected, for example, feel a stiff back and feel no longer agile enough. In addition, movement disorders of the facial muscles and voluntary movements of the extremities may occur after years of use. Patients suffering from bipolar disorder are very vulnerable to motor concomitants. Some long-term studies even indicate an increased risk of dying.

However, those affected are in a dilemma. If the medication is not taken further, the risk of relapsing increases. However, some research indicates that not all patients without a drug prescription relapse by far. In addition, long-term funds are costing healthcare systems around the world billions. Estimates suggest that spending on antipsychotic medicines worldwide is around $ 18.5 billion.

Medications lowered recurrence
Under the direction of scientist Stefan Leucht, a research team from the Technical University of Munich (TU) investigated the frequency of relapses with and without drugs. They analyzed the data from 116 methodological studies of approximately 6500 schizophrenia patients. The data were from 1959 to 2011, depending on their origin. The study results were published in the journal "The Lancet" and now support the use of drugs for relapse prevention.

The evaluation showed that patients had a recurrence rate of 27 percent when taking a drug. Patients who did not receive any active substance suffered from psychotic relapse in 64 percent of cases. In addition, patients who received a drug had to be hospitalized much less inpatients than patients without antipsychotic drugs. Here, the comparable clinical admission rate was 10 to 26 percent.

In addition, some data indicate that aggressive impulses broke off during medication and overall quality of life increased. However, these results are to be regarded with caution, since the evidence for this is limited, according to the researchers.

Subjects taking a drug, as opposed to the placebo groups, also showed increased side effects. Accordingly, they complained much more frequently of movement disorders (16 to nine percent), fatigue (13 to nine percent) and drastic weight gain (ten to six percent).

Effect of the remedies diminish over time
It was noticeable that, according to the data, the effectiveness of the remedies diminished over time. Although the results of the meta-analysis suggest that drug prophylaxis proved effective, the studies only followed the subjects for a maximum of two years. Against the background of temporary effectiveness, many questions remain open. Because the disease will last a lifetime for those affected. This made it impossible to investigate the long-term effects in terms of efficacy and side effects during the research work.

The dispute between psychiatrists will therefore continue, as the success of the medication is difficult to measure. In addition, doctors focus mostly on the alleviation of psychotic complaints. Schizophrenia sufferers, however, also suffer from cognitive disorders and impairment of their social skills. A complete cure does not exist until today. (Sb)

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