Current and future treatment modalities in schizophrenia: novel antipsychotic drugs and cognitive therapy

Abstract

In 60 years of use of antipsychotic drugs in schizophrenia, the only definite advance has been the introduction of clozapine. Some but not all other atypical or second-generation drugs may have small therapeutic advantages over conventional antipsychotics, but this remains controversial. New entrant atypicals seem unlikely to be therapeutically superior to conventional drugs, and glutamatergic drugs have yet to fulfill their theoretical promise. There is considerable current interest in novel mechanisms of antipsychotic action, but no such drugs have yet reached market authorization. A psychotherapeutic intervention, cognitive behavioral therapy has also found a place in the treatment of schizophrenia. However, the size of its effect against psychotic symptoms is small, and current evidence suggests no effect against negative symptoms or in reducing relapse.

Prevención de recaídas en la esquizofrenia: propuesta de un programa de intervención durante la fase prodrómica

“…Una vez aplicado este programa, cabe esperar que se reduzcan las tasas de recaída (Eisner, Barrowclough, Lobban y Drake, 2014;Klingberg et al, 2010;Montaño, Nieto y Mayorga, 2013;Prasko et al, 2011) y la duración de la rehospitalización en caso de que se produzca (McKenna y Mortimer, 2014;Shean, 2007). Esto se debe a la mejora de la adherencia a la medicación (Montaño et al, 2013;Prasko et al, 2011;Shean, 2007) y al reconocimiento de los marcadores de recaída, permitiendo reaccionar ante ellos con la mayor prontitud y eficacia posibles (Eisner et al, 2014), evitando la exacerbación de los síntomas y estados clínicos más graves.…”