Need for Better Medications
Progress in treating people with schizophrenia took a giant leap forward sixty years ago with the greatest advance in biological psychiatry in the history of medicine: the introduction of the typical antipsychotic drugs to treat psychosis. Advances in the treatment of schizophrenia have been less revolutionary and more incremental in the last quarter century. These small steps have made huge differences in the lives of hundreds of thousands of patients, but too many patients are still left out. The future outlook will be good if progress continues as it has, but incremental advances, by definition, take a long time to amount to a revolution.
Positive Progress and Negative Holdovers
One of the most notable steps forward in the last twenty years was the introduction of atypical antipsychotic medications. This has led to greater choice of medications with different, and arguably improved, side effect profiles. It has delivered effective treatment to people who were not helped by earlier drugs. Innovative and effective therapy programs also account for much of the recent progress.
Research for the development of better drugs with fewer side effects is an ongoing effort. Current antipsychotic medications are good, but they could be better. The newer drugs are said to be more effective and better tolerated than the older drugs, but their side effects can still be dangerous for some patients. Several studies have indicated that newer, more expensive drugs are not as superior to older drugs as once thought.
Current and future research should improve our understanding of the lingering side effects of antipsychotic medication. This knowledge could enable physicians to predict who is most at risk for adverse drug reactions. Patients then could be started sooner on medications they would have a better chance of tolerating, eliminating the need to employ a hit-or-miss strategy.
One lasting problem is the medical community's inability to effectively treat negative symptoms as well as positive ones. The typical antipsychotic drugs have little or no effect on negative symptoms. The atypical antipsychotics have some effect on these difficult, residual effects of the disease, but it is not enough.