Schizophrenia is a severe and chronic brain disorder in which a person interprets actual reality abnormally. It is a mental disorder that makes it difficult to think clearly, have normal responses to emotions, act normal in a social setting, and tell the difference between their own interpretation of reality and actual reality. There are several types of Schizophrenia: paranoid, undifferentiated, disorganized, residual, and catatonic schizophrenia.
The assumption is that schizophrenia is split or multiple personalities. Schizophrenia is defined as “split mind” but this references the disruption in normal balance of emotions and thinking. Schizophrenia is a chronic condition that requires lifelong treatment.
Paranoid Schizophrenia is the most common type of Schizophrenia. It is when a person loses touch with reality. A person’s ability to function and think normally daily is altered more than during other types of schizophrenia. However, it includes fewer problems with concentration, memory, and/or lack of emotion. It is still a serious lifelong condition that can lead to many different complications. Doctors do not completely know what causes this disorder.
Researchers have theories that it is caused by certain neural chemicals that are impaired and links have been found to abnormal regulation of the neurotransmitters dopamine and glutamate. Even though there is no specific known cause, there are risk factors that can increase the chances of being diagnosed with schizophrenia. The main risk factor is genetics. Other risk factors are environmental factors such as excessive stress, drug abuse, and/or abuse in general.
If a mother abused drugs, was malnourished, or got a viral infection during pregnancy these things could also result in Schizophrenia in the child.
There are a wide range of symptoms and secondary symptoms for Schizophrenia. The main symptoms caused by this disorder are hallucinations, delusions, anxiety, and depression. When a neurotransmitter chemical is released at the pre-synaptic membrane it binds to a specific receptor on the post-synaptic membrane triggering an electrical change. Once this process is done, the thought, feeling, or action is completed. An altercation or decrease in neurotransmitters at the post-synaptic membrane occurs when there is a neurological condition and can be associated with hallucinations and delusions.
There is no other known cause for these two symptoms, only that it is a neurological problem of sensory loss. The cause for depression is the decreased production of serotonin which in return will drop the serotonin levels in the brain. When a person with schizophrenia has the symptom of anxiety it could be due to a decrease in GABA activity.
There are a wide range of treatments to assist with Schizophrenia symptoms, even if the symptoms subside, treatment is still required so that they don’t reoccur. Hospitalization to provide adequate safety may be needed when symptoms become severe. Treatments can consist of medications such as antipsychotics and psychological therapy to help cope with the disorder. Antipsychotics in general are used to lower dopamine levels in one’s brain; Haloperidol, Olanzapine, Quetiapine, Risperidane, and Clozaril, are the most common drugs that target a wide range of Schizophrenia symptoms. Olanzapine and Risperidone are meant to antagonize serotonin and dopamine in the central nervous system.
An antagonistic drug binds to the dopamine and serotonin receptors to help decrease or block the agonist response or the responses that are in competition with these neurotransmitters. Dopamine is a neurotransmitter that reacts in certain brain cells to help with emotion and movement and serotonin helps regulate body cycle processes. Taking these medications will help decrease events of psychosis and bipolar behavior and/or autism by inhibiting dopamine and serotonin neurotransmitters.
Haloperidol alters effects of serotonin and dopamine. It serves as an anticholinergic, which inhibits the acetylcholine action at the receptor site in the parasympathetic nervous system and as an alpha-adrenergic blocker which inhibits the release of epinephrine or epi-like substances in the sympathetic nervous system.
This decreases the signs of schizophrenic behavior and improves behavior by creating a neutral state between rest and digest and flight or fight. Quetiapine is another drug that serves as an antagonizer of serotonin and dopamine along with being an antagonist to histamine and adrenergic receptors. Histamine causes capillary dilation and constriction of smooth muscle in the bronchials and decreases overall blood pressure.
This drug decreases delusions, hallucinations, and depression by blocking the action of histamine and the flight or fight response. Clozapine binds specifically to dopamine receptors but also has anti cholinergic blocking activity which in return decreases schizophrenic behavior by reducing flight or fight response and regulating emotion.
Anti-depression/anti-anxiety medication Welbutin and Ativan are used to target more specific symptoms. Welbutin is used to decrease depression symptoms by blocking the reuptake of dopamine and increases the uptake of norepinephrine and serotonin. Ativan depresses the central nervous system by increasing GABA activity, therefore decreasing anxiety.
All these drugs can have the side effects of weight gain, diabetes, and high blood pressure. MRI’s and PET scans can also be used to monitor physiologic damage and progression of schizophrenia.
Since the treatment is life long, there are some long term effects from the antipsychotics. These effects are acute dystonia or tardive dyskinesia, akathisia, and parakinsonism which are all cause by an imbalance of dopamine. Acute dystonia or tardive dyskinesia is involuntary movements of fingers, tongue, hands, legs, face, and trunk, which is caused by specifically binding to the dopamine receptors causing a significant influx of dopamine.
Parkinsonism is caused from the continuous drugs used to maintain balances in the CNS to the point where they impair motor control. This is also the cause for akathisia which is restless leg syndrome.
In general schizophrenia is hard to predict. Often symptoms should improve over time with the medication. During the early stages people might have increased episodes and have difficulty functioning. If medication is stopped, symptoms will return. Only 5% of people can be cured of schizophrenia and not have an episode again.
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