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Complications associated with schizophrenia include problems related to simultaneous drug abuse or side-effects related to prescription antipsychotic drug therapy. Concurrent substance abuse is associated with a higher incidence of violent behavior among schizophrenia sufferers. Drug therapy side effects include a number of potentially troubling conditions, such as blurry vision, dizziness upon standing, drowsiness, racing heartbeat, etc., but most such side effects subside within a few weeks.
Long-term use of antipsychotic medications can also lead to physical symptoms, such as uncontrollable tics (tardive dyskinesia). Physical side effects may also include rigidity, muscle spasms, tremors, and restlessness.
Because virtually all antipsychotic medications may affect metabolism, weight gain is a potentially serious complication of drug therapy. In a study published in the influential New England Journal of Medicine in 2005, researchers revealed that patients taking one popular atypical antipsychotic drug gained up to two pounds per month while taking the medication.
Patients on antipsychotics are also at increased risk for developing high blood sugar levels, type 2 diabetes, and altered blood lipid profiles. These conditions are known to increase the risk of cardiovascular disease, and such changes should be monitored carefully. Unfortunately, many patients discontinue medications against their physicians’ advice due to these and other side effects. In the aforementioned study, up to 74 percent of patients failed to complete the 18-month clinical trial due to complaints related to side effects.
For reasons that are not entirely clear, people with schizophrenia are three times more likely to be addicted to nicotine than the general public. Patients appear to be driven to smoke. Besides the obvious health risks associated with cigarette smoking, there is some evidence that smoking interferes with the effectiveness of some antipsychotic medications. Abrupt withdrawal from nicotine may worsen psychotic symptoms, however, so smoking cessation must be undertaken cautiously with the help of medical professionals.
There are presently no widely accepted strategies for the effective prevention of schizophrenia. Researchers are, however, investigating this possibility in laboratories around the world. For instance, Israeli scientists proposed recently that it may be possible to prevent the future development of schizophrenia in the unborn, when the pregnant mother is known to have been infected by a virus thought to trigger the disease.
Working with rodents that model the disease, investigators introduced a viral infection in pregnant females. Some animals were subsequently treated with antipsychotic medications, while others were left untreated. Pups born to untreated mothers were more likely to develop brain pathologies than pups born to those that had received the drugs. Researchers argued this suggests that prenatal drug therapy in cases of known infection might one day be used to prevent the development of neurological disorders such as schizophrenia. Other research suggests that, while prevention may not be possible, earlier diagnosis and earlier intervention may improve outcomes.
Another intriguing theory suggests that long-term dietary inadequacy of certain essential nutrients, including the omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), may be involved in the development of the disease. If so, replacing these nutrients may affect the relative risk of developing schizophrenia. The research has been prompted, in part, by the fact that patients with schizophrenia often have significantly lower blood levels of omega-3 fatty acids than healthy people.
The omega-3 fatty acids, commonly found in cold water fish such as tuna, salmon and other species are essential nutrients; the body cannot manufacture them but must have them for proper functioning. Among other important functions, they serve as crucial structural components of brain cell membranes and thus are directly related to the proper functioning of the central nervous system. According to this hypothesis, generations of people have been deficient in these nutrients due to relatively recent changes in the Western diet. This has resulted in a gradual rise in neurodevelopmental disorders, proponents argue. Restoring optimal levels of these nutrients through supplementation may help prevent schizophrenia. Supplementation with omega-3 fatty acids may also improve the prognosis of patients already diagnosed with the disease, according to this hypothesis.
Written by: Dale Kiefer
Medically reviewed : Jennifer Monti, MD, MPH
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