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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. September 2020

Polypharmacy

What is polypharmacy? Medication combination treatment, also called polypharmacy, has been utilised in clinical practice for patients who are unresponsive or partially responsive to antipsychotic monotherapies. What is the evidence for polypharmacy? Moderate to high quality evidence finds a medium-sized improvement in overall symptoms, and a small improvement in clinical response, with antipsychotic polypharmacy vs. monotherapy. There is also less study discontinuation for any reason with antipsychotic polypharmacy. However, studies assessing rates of relapse after switching from polypharmacy to monotherapies found no differences in relapse rates and more study discontinuation with polypharmacy. Moderate quality evidence finds antipsychotic polypharmacy is most…

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 quality evidence finds exercise therapy can improve symptoms, particularly negative symptoms, as well as improving quality of life and…

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 to low quality evidence finds a large effect of greater improvement in overall symptoms with adjunctive buspirone compared to placebo, with no differences in adverse effects apart from fewer extrapyramidal symptoms with buspirone. There were no significant effectsof buspirone in the subgroup analyses of positive, negative and general…

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 2020

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. October 2020

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…

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 to high quality evidence suggests adjunctive ginkgo biloba may specifically be…

Estrogen

What is estrogen (or ‘oestrogen’)? Estrogen is a hormone that has been proposed to confer a protective effect for schizophrenia. This theory is based on the observations that women tend to have a later age of onset of schizophrenia than men, and have a second peak of onset after menopause. In women, estrogen levels drop with age, particularly with the onset of menopause. This protective effect may mean that pre-menopausal women who develop schizophrenia may experience a less severe illness than males. Estrogen is not used routinely by people with schizophrenia, however some studies have trialed the use of estrogen…

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