Biology 202
2004 Second Web Paper
On Serendip

One problem with the wonders of modern-day medicine, as a friend of mine in medical school tells me constantly, is that they tend to work so well that those taking the medicines begin to believe that they no longer need it and therefore cease to take it. I began to think about this and remembered hearing a similar comment about patients of schizophrenia, and thought I would investigate this further, and a paper for this class would be the perfect opportunity to do so.

So naturally, the best place to begin would probably be the beginning – what is schizophrenia? It is a brain disease affecting one out of one hundred people. While men and women have equal chances of getting the disease, men tend to develop the symptoms earlier on, even as early as late teens(1). Early symptoms are paranoia and emotional indifference, which make schizophrenia hard to distinguish from other kinds of brain diseases like depression or bipolar disorder.

As the disease develops, two types of symptoms emerge; negative symptoms, when formerly enthusiastic, lively and social people suddenly become introverted, unemotional and reclusive, and positive symptoms, which are more forceful and include strong hallucinations and delusions. These positive symptoms are called the "psychosis", or "acute" phase of schizophrenia(2). This is the phase of schizophrenia most often portrayed by the media, the phase that you're most likely to find in movies or on TV. Many people in this phase are mistaken for being high or drunk, and indeed some patients begin to rely on illegal substances as self-treatment to keep some of the stronger symptoms in check.

While the exact cause of schizophrenia is unknown, there are indications that it is hereditary. According to Schizophrenia.com, people with a close relative who has schizophrenia run a higher risk - as high as 50% - of eventually getting it themselves. Scientists are looking for particular genes that may either cause or predispose one to the illness, much like what was recently done for heart attacks. But schizophrenia is a brain, not a genetic disease, and is generally thought to be caused by an imbalance between the brain chemical dopamine and other brain chemicals such as serotonin(3) or glutamate(4). Dopamine controls one's emotions, and some of its neurotransmitters are also thought to affect attention and motivation. Serotonin controls sleep and appetite, and also acts as a stimulant of physical movement. Glutamate is the nervous system's main neurotransmitter between cells.

Schizophrenia is also thought to be caused by certain physical deformities within the brain. While this is not a reliable or fool-proof method of predicting who might become schizophrenic, the most common attribute which sufferers have is enlarged ventricles. Ventricles are holes within the brain which transport fluids from one part of the brain to another. The Surgeon General, in his 2002 report on the causes of schizophrenia(5), also cites "environmental factors" as one of the possible causes of schizophrenia and why family members of one sufferer run the greater risk of developing symptoms, but he fails to list what those factors might be.

For those diagnosed with schizophrenia, the most common and effective method of treatment is drug therapy, which treats the chemical imbalances previously described and which also keep the psychotic symptoms – hallucinations, et cetera – from returning. Recommended dosages differ from patient to patient, as each case is different. Traditional medications include Haloperidol (trade name Haldol), which treats hyperactivity and mania but which is known to cause other problems such as lethargy, and Trifluoperazine, called Stelazine, which treats anxiety and nausea but fails to treat the withdrawal. Other medications include Loxapine, Perphenazine and Prolixin, all of which treat only some of the symptoms and none of which cure schizophrenia(6). And, of course, the problem with treating the symptoms and not the causes of the disease is that patients tend to think they've been cured, and therefore cease taking their medications. The disease is permanent – symptoms might disappear for a while but generally return.

While there is no cure for schizophrenia, so much research is being invested into discovering more about the disease. Doctors, hospitals, charities and medical societies are all donating time, effort, money and resources to find better treatments for the disease, and perhaps, one day, a cure. Though the end may not yet be in sight, the outlook for schizophrenics and their families is good.

References

1.) 1) Schizophrenia.com

2.) 2) Mental Wellness Mental Wellness Online: www.mentalwellness.com/

3.) 3) Mental Wellness

4.) 4) Glutamatergic Aspects of Schizophrenia

5.) 5) Schizophrenia.com

6.) 6) Schizophrenia.com


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