Receptor Properites of Atypical Antipsychotics: Implications for Cognition
Stephen M. Stahl, MD, PhD
Chairman and CEO
Neuroscience Education Institute
Carlsbad, Calif.
Clinical Research: Abbott, Asahi, AstraZeneca, Bristol-Myers Squibb, Cephalon, Inc., Cypress Bioscience Inc., Eli Lilly, GlaxoSmithKline, Pfizer, Pierre Fabre, and Wyeth; Consultant: Abbott, Asahi,AstraZeneca, Bristol-Myers Squibb, Cephalon, Cypress Bioscience, Eli Lilly, GlaxoSmithKline, Organon, Pfizer, Pierre Fabre, Sanofi-Synthelabo, and Wyeth. Targeting Cognition to Improve Outcomes in Schizophrenia
Herbert Y. Meltzer, MD
Bixler Professor of Psychiatry and Pharmacology
Vanderbilt University
Nashville, Tenn.
Clinical Grants: Abbott Laboratories, Acadia Pharmaceuticals, Janssen Pharmaceutica Products, L.P., Organon, Prentiss Incorporated, and Solvay S.A.; Consultant: Acadia, Bristol-Myers Squibb Company, Eli Lilly and Company, Janssen, Novartis AG, Pfizer Inc., Solvay, and Vanda Pharmaceuticals; Speaker's Bureau: Pfizer. Managing Metabolic Risks of Antipsychotic Therapy
Jonathan Meyer, MD
Assistant Adjunct Professor of Psychiatry
University of California, San Diego
Staff Psychiatrist, Veterans Affairs
San Diego Healthcare System
San Diego, Calif.
Clinical Grants: Bristol-Myers Squibb; Consultant/Speaker's Bureau: Bristol-Myers Squibb, Janssen, and Pfizer. New Horizons in Antipsychotic Therapy
Daniel R. Weinberger, MD
Chief, Clinical Brain Disorders Branch
National Institute of Mental Health
Bethesda, Md.
Consultant: AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen, Otsuka America Pharmaceutical, Inc., and Pfizer.
|
Schizophrenia has a devastating impact on patients and their families, interfering with virtually every aspect of life and disrupting social, emotional, and occupational functioning. The first generation of antipsychotic agents represented an important step forward in meaningful therapy for patients with schizophrenia. The main limitations associated with this class of drugs include side effects such as extrapyramidal symptoms and their inability to improve cognitive function. In the past, clinicians, patients, and families focused on achieving stability for the patient, defined as control of positive symptoms such as delusions and auditory hallucinations. Today, however, a new model is emerging in psychiatry characterized by a more hopeful view of how patients may function in their family settings, in their communities, and in the workplace. In a recent national consumer survey conducted by Harris International, patients with schizophrenia were asked about their attitudes toward their current and future treatment. They recognized the value of controlling positive symptoms, but 53% said their psychotic symptoms were not fully controlled on their current antipsychotic medication. Many patients also rated their current medications as inadequate for controlling symptoms such as depression, negative symptoms, and lack of ability to concentrate and focus. A large number of respondents said they believed new medications may help improve these symptoms. A key element of this more optimistic view is cognitive function. The second-generation antipsychotic agents (also known as atypical antipsychotic drugs) offer new possibilities in recovery for these patients as the data accumulate showing that the novel mechanism of action of this class of drugs can yield improvements in a variety of cognition parameters. Basic and clinical research continues to further illuminate the effects of the atypical antipsychotics, including the causes of variability of individual patient responses to these drugs. A better appreciation of the similarities and differences among medical therapies can help psychiatrists optimize treatment for their patients.
|
