For decades there has been almost no improvement in the medical treatment of schizophrenia, one of the most severe and devastating mental illnesses, but recent advances have raised hopes for progress.
The condition often only hits the headlines after violent attacks by sufferers, such as a schizophrenic patient who stabbed a nurse to death last week in the French city of Reims.
But French psychiatrist Sonia Dollfus stressed that such cases of violence by people with schizophrenia are “extremely rare”.
“All the work done over the years trying to destigmatize this disease is wiped out in 24 hours,” Dollfus told AFP.
About one in 300 people worldwide have schizophrenia, according to the World Health Organization.
It causes a wide range of distressing delusional disorders, which vary in intensity among patients, but often disrupt their lives enormously.
It is estimated that at least five percent of patients with schizophrenia die by suicide.
The condition is usually treated with a combination of antipsychotic medications, reintegration social support, and psychological therapy.
Scottish psychiatrist Robin Murray, who has spent decades researching schizophrenia, told AFP that when it came to medication, “treatment hasn’t changed dramatically” in the last 20 to 30 years.
She added that psychological therapy had improved during that time.
But unlike numerous other mental disorders, particularly neurotic conditions, serious medication remains the cornerstone of schizophrenia treatment.
Innovation
For drugs, there has been a “blank period since the 2010s when drug labs really pulled back from psychiatry,” Dollfus said.
But there has been some innovation recently, he added.
One development has been apps that can track patient progress, ensure timely follow-up sessions, and contact psychiatrists as needed.
Another is a new treatment approved by the US Food and Drug Administration last month.
The treatment, developed by Israeli pharmaceutical company Teva and French MedinCell, involves the drug risperidone which has long been used for schizophrenia.
It has traditionally been prescribed as a daily pill, but the new treatment is given by injection, allowing the drug to be released gradually into the body over several weeks.
This makes it impossible for patients to miss a daily pill.
Medication interruptions, often caused by the psychosis caused by the illness, are a common problem in the treatment of schizophrenia.
For example, according to various sources, the Reims attacker was not taking any medications.
‘Really promising’
This new way of delivering an old drug is not the kind of revolution a new drug would represent. But progress could soon be made in this area.
Dollfus said some drugs currently under investigation are “really interesting” because they work differently than those of the past.
Traditionally, antipsychotic drugs used to treat schizophrenia aim to block the action of dopamine, a molecule that acts as a chemical messenger in the brain.
However, dopamine appears to play a complex role in schizophrenic patients, some may have excessive levels in some respects and insufficient levels in others.
Traditional antipsychotic medications, which tend to work well at stopping some symptoms like hallucinations, don’t help in other areas, like loss of willpower or struggles with language and speech.
Recent research has focused on finding other molecules that regulate rather than block dopamine, while also acting on other areas thought to be involved in schizophrenia.
These treatments, such as one that targets a protein called TAAR1, are still far from being available to patients.
But the TAAR1 drug has had positive results from the most advanced phase of the trials, known as phase 3.
“This is a really promising avenue,” said Dollfus.
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