Monday, November 17, 2014

New Hope for Patients with Treatment-Resistant Schizophrenia

That is the title of this article I am writing about. “Researchers at Northwestern University Feinberg School of Medicine have discovered a genetic biomarker that could help identify schizophrenia patients who are resistant to antipsychotic drugs (about 30 percent of all schizophrenia patients).  ‘Many treatment-resistant patients are not identified as such and are treated with mixtures of ineffective antipsychotic and other drugs, accruing little benefit and serious side effects, said Herbert Meltzer, M.D., professor in psychiatry and behavioral sciences, pharmacology, and physiology.  By definition, treatment-resistant schizophrenia patients are those who continue to have psychotic symptoms, such as delusions and hallucination, after they have completed at least two rounds of conventional antipsychotic medications.” This is hope I know a lot of people still have voices when they are taking antipsychotics medications and that is a hard pill to swallow.  If there is some way to help them it would be great.
The article goes on to say: “For the research, Meltzer, Jiang Li, Ph.D., a research assistant professor in Psychiatry and Behavioral Sciences, conducted a genome-wide association study on a group of Caucasian schizophrenia patients – a combination of both treatment-responsive and treatment-resistant patients. In the treatment-resistant group, the researchers found a mutation in the dopa decarboxylase gene, which is involved in the production of dopamine and serotonin. Certain variations of this gene have been linked to psychosis in previous studies.  Many patients who were once treatment-resistant do eventually respond to a drug called clozapine.  However, it’s usually not administered in early treatment stages due to potentially severe side effects and required weekly blood monitoring.”  They need something that works as soon as possible so they do not get discouraged with seeking treatment.  They need some kind of medication that manages their symptoms and gives them some kind of relief.
The article ends with: ‘“This biomarker can be used to easily identify patients who should be treated with clozapine, avoiding the use of drugs that are not able to help them.  This can be life-saving,’ said Meltzer, who has dedicated years to developing atypical antipsychotic drugs to help these patients.  He was the lead researcher in the landmark clinical trial that led to FDA’s approval of clozapine in 1989.  Not every patient who benefits from clozapine, however, has the specific dopa decarboxylase genetic mutation.  The researchers will work with a greater variety of schizophrenia patients in the future – particularly patients from other ethnic groups – to look for other biomarkers and treatment options for those who don’t get better with conventional treatments. ‘In a broader sense, this work defines treatment-resistant schizophrenia as a distinct subtype of the illness,’ said Meltzer.  Schizophrenia is one of the most severe and rarest of the mental health disorders, occurring in about one in 100 people. It is characterized by symptoms such as hallucinations, delusions, paranoia, cognitive impairment, social withdrawal, self-neglect, and loss of motivation and initiative.  The finding were published in the journal Schizophrenia Research.” It is finally defined as treatment-resistant.  Again we cannot lump all schizophrenics in the same category.  I just wish there were more options there just clozapine for treatment.  I do not know in my lifetime if I will ever find out everything about this disease.  I would like to also to find out why I have it and how.


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