Topics tagged with "Schizophrenia additional treatments"

Biofeedback

What is biofeedback? Biofeedback is a technique in which information about the person’s body is fed back to the person so that they may be trained to alter the body’s conditions. Physical therapists use biofeedback to help stroke victims regain movement in paralyzed muscles. Other specialists use biofeedback to help their patients cope with pain. It is also commonly used to reduce stress and anxiety, and to encourage relaxation. What is the evidence for biofeedback? Low quality evidence from few small studies is unable to determine the benefits of biofeedback for patients with schizophrenia. More research is needed. August 2019

Antipsychotic polypharmacy

What is antipsychotic polypharmacy? Antipsychotic combination treatment, also called antipsychotic polypharmacy, has been utilised in clinical practice for patients who are unresponsive or partially responsive to antipsychotic monotherapies. Please also see the treatments for medication-resistant schizophrenia topic for augmentation with other pharmaceutical agents. What is the evidence for antipsychotic polypharmacy? Moderate to high quality evidence suggests a small effect of less discontinuation for any reason, and moderate quality evidence suggests better clinical response with antipsychotic polypharmacy versus monotherapy. Moderate quality evidence suggests antipsychotic polypharmacy is most often associated with the use of first generation antipsychotics, inpatient status, and a diagnosis…

Transcranial direct current stimulation

What is transcranial direct current stimulation (tDCS)? tDCS is a non-invasive form of brain stimulation similar to transcranial magnetic stimulation, but instead of using magnets, it uses a low-intensity, constant current applied through scalp electrodes. Generally, anodal stimulation induces an increase of cortical excitability, whereas cathodal stimulation decreases cortical excitability, with effects that last beyond the stimulation period. Dose involves current intensity, duration of stimulation and size of electrodes. While most people with schizophrenia respond adequately to antipsychotic medication, some find it is not completely effective for all of their symptoms. tDCS is currently being investigated as an additional treatment…

Exercise therapy

How is exercise beneficial for people with schizophrenia? Individuals with serious mental illnesses are more likely to be sedentary than the general population and are consequently at high risk for chronic medical conditions associated with inactivity. Physical activity reduces the risk of these medical conditions, and positive psychological effects have also been reported, including improved quality of life. Exercise also has the potential to alleviate secondary symptoms including depression, low self-esteem and social withdrawal. What is the evidence for exercise? Moderate to high quality evidence suggests exercise therapy can improve symptoms, quality of life, cognition, and functioning. Moderate to low…

Serotonin modulators

What are serotonin modulators?  Serotonin is a neurotransmitter. Atypical antipsychotics are thought to have some affinity for serotonin 5-HT receptors, for example clozapine, quetiapine, and olanzapine, among others. This suggests a potential for the use of serotonin-specific medications in the treatment of schizophrenia. What is the evidence for adjunctive serotonin modulators? Moderate quality evidence suggests a small effect of adjunctive buspirone, tandospirone, tropisetron, or mianserin for improving positive symptoms, and a medium-sized effect of buspirone or tandospirone for improving overall symptoms. Moderate to low quality evidence suggests a large effect for overall and negative symptoms with adjunctive granisetron, ondansetron, or…

Adenosine modulators

What are adenosine modulators? Adenosine modulates dopamine and glutamine which are both implicated in schizophrenia’s pathophysiology; therefore adenosine modulators may be useful adjunctive treatments for schizophrenia. Allopurinol is used for the treatment of gout and hyperuricemia; it inhibits purine degradation and subsequently increases adenosine levels. Dipyridamole and propentofylline inhibit cellular reuptake of adenosine and increases extracellular adenosine concentration. What is the evidence for adenosine modulators? Moderate to low quality evidence suggests adjunctive adenosine modulators (particularly dipyridamole and propentofylline) may improve symptoms, particularly positive symptoms, in people with schizophrenia. September 2019

Testosterone

What is testosterone? Testosterone is a hormone that has shown to be reduced in people with schizophrenia. It is not used routinely as a therapy for schizophrenia, however some studies have trialed the use of testosterone as an additional, adjunctive treatment to standard antipsychotic treatments. What is the evidence for testosterone supplementation? Low quality evidence is unclear as to the benefit of testosterone as an adjunctive therapy for schizophrenia. Further research is required. March 2019

Glutamate receptor modulators

What are glutamate modulators?  Antipsychotic medications predominantly target the dopamine neurotransmitter system, with some efficacy for alleviating the positive symptoms of schizophrenia. However, the persistence of negative and cognitive symptoms suggests that other mechanisms are also likely to be involved. The glutamate hypothesis of schizophrenia proposes that reduction of glutamatergic N-methyl-D-aspartate (NMDA) receptor function represents a primary neuropathology in schizophrenia. Therefore, glutamate receptor modulators have been suggested as an adjunctive therapy to standard antipsychotic treatments, when individuals have sub-optimal responses to treatment. The glutamate receptor modulators that have been trialed in schizophrenia are predominantly amino acids, and act on several…

Nicotine

How is nicotine relevant for schizophrenia?  The proportion of tobacco smokers amongst people with schizophrenia tends to be much higher than in the general population (for information, see comorbid conditions substance use/smoking topic). This has led to the suggestion that perhaps nicotine (the psychoactive component of tobacco), in addition to ongoing antipsychotic medication, is exerting beneficial effects for symptom severity or every day functioning. Is there any evidence for the use of nicotine as a treatment for schizophrenia? No evidence is available to support the use of nicotine for relieving symptoms or improving functioning in people with schizophrenia. March 2019

Herbal medicines

What are herbal medicines?  Herbal treatments can include traditional Chinese medicines, as well as more common herbal medicines such as gingko biloba or folate. Herbal treatments have been suggested as an adjunctive therapy, which is a supplementary treatment administered in conjunction with a patient’s ongoing medications in an attempt to treat symptoms or improve functions that are not addressed by these medications alone. What is the evidence for adjunctive herbal medicines? High quality evidence shows adjunctive ginkgo biloba can improve symptoms, particularly when combined with chlorpromazine or haloperidol. Moderate quality evidence suggests adjunctive ginkgo may specifically be effective for the…

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