Sunday, June 15, 2008

Schizophrenia, Still Figuring it Out


New York Times reporter Benedict Carey likes to write about mental health issues. Today, he talks about the diverse presentation of schizophrenia, as well as variations patients have with regard to treatment response. Carey writes:

The findings confirmed in a rigorous way what psychiatrists who work in the trenches know from experience: Many patients bounce from medication to medication for years. Some find a drug they can live with; others do not and choose not to take drugs at all.

Psychosis can be miserable — and it says something when people prefer its twisted torments to being on a medication.

The shortcomings of the drugs, in turn, cast doubt on one working theory of the biology behind schizophrenia. The drugs act on the brain by numbing cells to a brain chemical called dopamine, which was thought to be overactive for some reason in people with schizophrenia. Most researchers now regard this so-called “dopamine hypothesis” as simplistic at best.

He goes on to say that, according to European studies,with the right support, there are patients with schizophrenia who can be maintained for years without medications. Wouldn't it be nice if we knew exactly which patients they were?