1. 3. 2010
The classical antipsychotic drugs exert primarily antidopaminergic properties, which are responsible also for their side-effects such as hyperprolactinemia and extrapyramidal syndrome. Nevertheless, psychotogenic pathways in the brain involve several different mechanisms, which could serve as targets of antipsychotic modalities, e.g., facilitation of glutamatergic neurotransmission, blockade of serotonin 5-HT2A receptors, expression of BDNF and bcl2, inhibition of GSK-3β phosphorylation and thus apoptosis etc.[1] Recent naturalistic trials brought updated experience with regard to efficacy, effectiveness and side-effect profile of antipsychotics and the comparison of antipsychotics of the first and second generation. In addition, recent developments in the treatment of schizophrenia involved also psychoeducation[2] and so called ITAREPS (Information Technology Assisted Relapse Prevention in Schizophrenia)[3], which improve adherence to treatment and therefore decrease significantly the relapse rate.
References:
[1] Horáček J, Bubeníková-Valešová V, Kopeček M, Páleníček T, Dockery C, Mohr P, Höschl C. Mechanism of action of atypical antipsychotic drugs and the neurobiology of schizophrenia. Drugs. 20, 2006; 5:389-409.
[2] Motlova L, Dragomirecka E, Spaniel F, Goppoldova E, Zalesky R, Selepova P, Figlova Z, Höschl C. Relapse prevention in schizophrenia: does group family psychoeducation matter? One-year prospective follow-up field study. Int J Psychiat Clin Pract, 2006; 10(1): 38-44
[3] Spaniel F, Vohlídka P, Kožený J, Novák T, Hrdlička J, Motlová L, Cermák J, Höschl C. The Information Technology Aided Relapse Prevention Programme in Schizophrenia:an extension of a mirror-design follow-up.Int J Clin Pract. 62, 2008;12:1943-1946