After 70 years, the pharmacotherapy of schizophrenia needs changes.
To date, available antipsychotic medications have been limited to those that act on dopamine and serotonin.
Although antipsychotics reduce symptoms of schizophrenia, safer and more effective medications are needed.Nick Youngson/Pix4free Since the first antipsychotic medication, chlorpromazine, was developed in the early 1950s, it could be argued that not all that much has changed in the pharmacological treatment of psychotic disorders like schizophrenia.To be sure, the U.S. Food and Drug Administration's 1989 approval of clozapine brought us an important new “gold standard” to manage “treatment-resistant” schizophrenia that does not respond significantly to other antipsychotic medications.
But while those newer medications have represented upgrades, existing antipsychotic medications still leave a lot to be desired. Despite its superior efficacy, clozapine remains an underutilized “third-line” option due to its risk of serious and potentially life-threatening side effects that require careful monitoring like agranulocytosis and myocarditis.
Further, a third or more of patients with schizophrenia don’t significantly benefit from antipsychoticincluding clozapine. And medications only help modestly, if at all, with certain types of symptoms of schizophrenia like cognitive impairments or “negative” symptoms such as amotivation.
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