Psychopharmacological treatment of schizophrenia

Discusses psychopharmacological treatment of schizophrenia. Schizophrenia, as a nosological entity, belongs under the classification of psychoses. The psychopharmacological agents that are most specifically effective in all psychotic conditions, except for depressions, are the neuroleptic drugs--also referred to as antipsychotics or major tranquilizers. Neuroleptic drugs are characterized by their effects on the ascending reticular formation, which result in reduced reactivity to external and internal stimuli and in decreased spontaneous activity. No definitive explanation of the therapeutic effects of neuroleptic treatment in schizophrenic patients is yet available, but several theories exist, and active neuropharmacological research in this field is constantly providing new clues. Neuroleptic drugs diminish arousal of the central nervous system (CNS) without disinhibiting the higher cortical centers at any dose level. In this respect they differ essentially from the minor tranquilizers (anxiolytic sedatives, such as barbiturates, benzodiazepines or alcohol). These minor tranquilizers are biphasic in their action, and at low dose levels, induce pseudostimulation. This stimulation is in effect a disinhibition of behavior and affect that interferes significantly with such essential cognitive ego functions as differentiation, abstraction, and synthesis. The therapeutic effect of neuroleptic-induced decrease of arousal, through inhibition of the brain-ascending reticular formation, probably results from a decrease of excessive perceptual input in schizophrenic conditions where "jamming" of the CNS--through a disproportionate ratio of input and arousal to central processing capacity has occurred and has led to psychotic disintegration. (PsycINFO Database Record (c) 2016 APA, all rights reserved)