Schizophrenia Information by Ray Sahelian, M.D. Natural treatment for schizophrenia

Schizophrenia is a serious mental disorder with a profound impact on patients, their caregivers and society. Schizophrenia is associated with abnormalities of multiple neurotransmitter systems, including dopamine, serotonin, GABA, and glutamate. Some mental health experts have called  for the term schizophrenia to be dropped, saying it has no scientific validity, is imprecise and stigmatizing. "It is a harmful concept," says Professor Marius Romme, a visiting professor of social psychiatry at the University of Central England in Birmingham. He adds that symptoms such as delusions, hearing voices and hallucinations are not the results of the illness but may be reactions to traumatic and troubling events in life. Richard Bentall, a professor of clinical psychology at the University of Manchester, said the concept of schizophrenia is scientifically meaningless. "It groups together a whole range of different problems under one label -- the assumption is that all of these people with all of these different problems have the same brain disease," he added. Paul Hammersley of the University of Manchester who recently helped launch The Campaign for the Abolition of the Schizophrenia Label (CASL), said there is no agreement on the cause of the illness or its treatment. One expert has called for replacing the term schizophrenia with the label dopamine dysregulation disorder, which may more accurately reflect what is happening in the brain of someone who is psychotic.

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Natural Supplements for Schizophrenia
I am not aware of any supplements that are effective for the treatment of schizophrenia.
   Quercetin has potential for the treatment of neuroleptic -induced extrapyramidal side effects of schizophrenia medications, such as from haloperidol. Quercetin is a powerful antioxidant that may protect brain cells from damage.

Cause of schizophrenia
There are many causes for schizophrenia, the most likely being genetic. However, environmental causes should also be looked into.
   Pregnant women with high levels of antibodies to a common parasite, Toxoplasma gondii, seem to run the risk of having a child who will develop schizophrenia or a schizophrenia -like disorder in adulthood. Infection with Toxoplasma is widespread. People can pick it up quite easily, especially when cats are around because the animals frequently harbor the parasite. A pregnant woman who contracts toxoplasmosis can pass the parasite on to her unborn baby, with serious consequences. On the other hand, a woman who has had the infection and has become immune cannot pass the organism on to her baby during pregnancy. Toxoplasmosis is a parasitic infection that often causes no symptoms in individuals with healthy immune systems. However, it can be dangerous in pregnant women and immunocompromised patients. Carried by about 60 million in the U.S. it is the third leading cause of death from food-borne illness.
   A history of epilepsy -- history of seizures -- more than doubles the risk of developing schizophrenia or schizophrenia -like psychosis.
   Using marijuana on a regular basis increases the risk of one day developing a psychotic illness such as schizophrenia in those who are predisposed to the condition.
   Children born to mothers who experience severe stress in the first trimester of pregnancy are at increased risk for developing schizophrenia later in life.
   A serious central nervous system viral infection during childhood increases the risk of schizophrenia later in life.

Schizophrenia prediction in teenagers
Five characteristics increase the likelihood that a teen will develop schizophrenia: a genetic risk for schizophrenia combined with recent decline in function; higher levels of unusual thought content; more suspicion/paranoia; more social impairment; and past or current substance abuse.

Schizophrenia and Autoimmune conditions
Schizophrenia may be associated with a larger range of autoimmune diseases than previously suspected. Schizophrenia affects about 1 percent of the population and can trigger delusions, paranoia, and hallucinations. It is very difficult to treat. A few autoimmune disorders are thought to play some role in schizophrenia. Those with a history of one or more autoimmune diseases have a 45 percent higher risk of schizophrenia. Schizophrenia patients had a higher prevalence of nine autoimmune disorders compared with comparison subjects. Parents of schizophrenic patients have a higher prevalence of 12 autoimmune diseases. The autoimmune disorders -- thyrotoxicosis, celiac disease, acquired hemolytic anemia, interstitial cystitis, and Sjogren's syndrome -- occur more often in schizophrenic patients and their parents compared with the controls and their parents. American Journal of Psychiatry March 2006.

Types of Schizophrenia
Catatonic schizophrenia
Paranoid schizophrenia

Schizophrenia treatment
The ideal treatment for schizophrenia may not be a single pharmacological agent but several agents that match the different expressions of the illness, in combination with psycho-social interventions. Most patients with schizophrenia quit taking their drugs. In one study, patients taking Seroquel did not quit for 10 months on average, those on Zyprexa lasted seven months and those taking Risperdal quit on average after four months. Patients complained that the new drugs often made them sleepy, confused and caused weight gain. More than 90 percent of prescriptions for antipsychotics are for such second-generation drugs, accounting for $10 billion in U.S. sales.
   Working with farm animals helps those with schizophrenia and other psychiatric conditions develop self-confidence and better coping skills.

Schizophrenia medication
Typical and atypical antipsychotic agents differ in their receptor-binding affinities, which are related to their differing side-effect profiles. Novel therapeutic strategies include normalisation of synaptic dopamine or serotonin levels, serotonin receptor antagonism and modulation of cerebral protein synthesis.
    A head-to-head comparison of five schizophrenia drugs found that most newer treatments are no better than an older generic drug, despite their higher cost. The lone exception, Eli Lilly and Co.'s Zyprexa, may be better than the other medicines but users experienced dramatic weight gain and developed a higher risk of diabetes. The drug is also the most expensive. The study used the amount of time patients stayed on a drug to help gauge its effectiveness. In all, 74 percent of the 1,432 volunteers at 57 study sites stopped taking the medication they were originally assigned. Only the schizophrenics taking Zyprexa, also known as olanzapine, stuck with it significantly longer than the other four. But even 64 percent stopped taking it after 18 months. The discontinuation rate was higher among the other four drugs: Seroquel (quetiapine) from AstraZeneca Plc; Risperdal (risperidone) from Janssen Pharmaceutical, a wholly owned unit of Johnson & Johnson; Geodon (ziprasidone) from Pfizer Inc., and perphenazine, which has been around since the 1950s and is available in generic form. One surprise was that perphenazine's side effects such as tremor, rigidity, stiff movements and muscle restlessness were not as common as expected. Patients tolerated it just as well as some of the newer drugs, and it was no less effective. And it was far cheaper. At the average doses used in the study, a month's supply of perphenazine capsules costs about $50 - compared with roughly $390 for Geodon, $425 for Risperdal, $475 for Seroquel, and $660 for Zyprexa.

Drug Combination in Schizophrenia
Schizophrenics who take two antipsychotic drugs show no more improvement than those on a single drug, raising doubts about the benefit of using multiple medicines to treat the disease. A study, published in the New England Journal of Medicine, tested 68 patients who responded poorly to clozapine, the generic version of Novartis AG's Clozaril. Half the group took clozapine along with Johnson & Johnson's antipsychotic Risperdal. The other half were given clozapine with a placebo. Both groups showed the same degree of improvement during the 26-week trial, but there was a slight deterioration in memory among the ones taking Risperdal. The results offer no support for the idea of prescribing multiple drugs, at least from the same class, especially to people who got little help from clozapine.

Schizophrenia and Marijuana
Adolescents who regularly smoke marijuana risk damaging a key brain pathway associated with language development and some predisposed to schizophrenia may develop the illness early. Brain scans revealed microscopic abnormalities in a region of the brain that governs higher aspects of language and listening functions in adolescents who are heavy marijuana smokers. Similar damage to the bundle of fibers, called the arcuate fasciculus, that connect the Broca's area in the left frontal lobe and the Wernicke's area in the left temporal lobe was found in the brains of marijuana smokers and schizophrenics studied.

Music and Schizophrenia
Music therapy many help to ease the depression, anxiety and emotional withdrawal symptoms of schizophrenia. In a small study, researchers at Imperial College London found that encouraging patients to express themselves through music seemed to improve their symptoms. The patients in the study received standard therapy alone or with the musical component, which consisted of eight to 12 music sessions. They were encouraged to express themselves with a range of musical instruments.

Schizophrenia Research Update
On the trail of a cognitive enhancer for the treatment of schizophrenia.
Prog Neuropsychopharmacol Biol Psychiatry. 2005 Feb;29(2):219-32.
The aim of this critical review is to address that the study of cognition and antipsychotics is not always driven by logic and that research into real pro-cognitive drug treatments must be guided by a better understanding of the biochemical mechanisms underlying cognitive processes and deficits. Many studies have established that typical neuroleptic drugs do not improve cognitive impairment. Atypical antipsychotics improve cognition, but the pattern of improvement differs from drug to drug. Diminished cholinergic activity has been associated with memory impairments. Why atypical drugs improve aspects of cognition might lie in their ability to increase dopamine and acetylcholine in the prefrontal cortex. An optimum amount of dopamine activity in the prefrontal cortex is critical for cognitive functioning. Another mechanism is related to procedural learning, and would explain the quality of the practice during repeated evaluations with atypical antipsychotics due to a more balanced blockage of D2 receptors. Laboratory studies have shown that clozapine, ziprasidone, olanzapine, and risperidone all selectively increase acetylcholine release in the prefrontal cortex, whereas this is not true for haloperidol and thioridazine. A few studies have suggested that cholinomimetics or AChE inhibitors can improve memory functions not only in Alzheimer's disease but also in other pathologies. Some studies support the role of decreased cholinergic activity in the cognitive deficits while others demonstrate that decreased choline acetyltransferase activity is related to deterioration in cognitive performance in schizophrenia. Overall, results suggest the hypothesis that the cholinergic system is involved in the cognitive dysfunctions observed in schizophrenia and that increased cholinergic activity may improve these impairments. Furthermore, a dysfunction of glutamatergic neurotransmission could play a key role in cognitive deficits associated with schizophrenia. Further meta-analysis of various clinical trials in this field is required to account for matters on the grounds of evidence-based medicine.

Theories of schizophrenia: a genetic-inflammatory-vascular synthesis.
BMC Med Genet. 2005 Feb 11;6(1):7. Hanson DR, Gottesman II.
Department of Psychiatry, VA Medical Center (116A), One Veterans Drive, Minneapolis, MN
Schizophrenia, a relatively common psychiatric syndrome, affects virtually all brain functions yet has eluded explanation for more than 100 years. Whether by developmental and/or degenerative processes, abnormalities of neurons and their synaptic connections have been the recent focus of attention. However, our inability to fathom the pathophysiology of schizophrenia forces us to challenge our theoretical models and beliefs. A search for a more satisfying model to explain aspects of schizophrenia uncovers clues pointing to genetically mediated CNS microvascular inflammatory disease. DISCUSSION: A vascular component to a theory of schizophrenia posits that the physiologic abnormalities leading to illness involve disruption of the exquisitely precise regulation of the delivery of energy and oxygen required for normal brain function. The theory further proposes that abnormalities of CNS metabolism arise because genetically modulated inflammatory reactions damage the microvascular system of the brain in reaction to environmental agents, including infections, hypoxia, and physical trauma. Damage may accumulate with repeated exposure to triggering agents resulting in exacerbation and deterioration, or healing with their removal. There are clear examples of genetic polymorphisms in inflammatory regulators leading to exaggerated inflammatory responses. There is also ample evidence that inflammatory vascular disease of the brain can lead to psychosis, often waxing and waning, and exhibiting a fluctuating course, as seen in schizophrenia. Disturbances of CNS blood flow have repeatedly been observed in people with schizophrenia using old and new technologies. To account for the myriad of behavioral and other curious findings in schizophrenia such as minor physical anomalies, or reported decreased rates of rheumatoid arthritis and highly visible nail fold capillaries, we would have to evoke a process that is systemic such as the vascular and immune/inflammatory systems. SUMMARY: A vascular-inflammatory theory of schizophrenia brings together environmental and genetic factors in a way that can explain the diversity of symptoms and outcomes observed. If these ideas are confirmed, they would lead in new directions for treatments or preventions by avoiding inducers of inflammation or by way of inflammatory modulating agents, thus preventing exaggerated inflammation and consequent triggering of a psychotic episode in genetically predisposed persons.

Schizophrenia questions
Q. My daughter has paranoid schizophrenia since about age 16. She has tried several medicines and they all have weight gain and so far Clozaril seem to be a little bit better for her. She has only been on it since the beginning of January. I would like to know whether Quercetin will keep her from hearing voices and being paranoid all the time. Tell me how this natural supplement will help her?
     A. It is very unlikely that quercetin would help someone with schizophrenia in terms of treatment of the condition, perhaps quercetin may help the side effects of schizophrenia drugs. At this time I am not aware of any supplements or herbs that can control this condition.