Topics tagged with "Schizophrenia and mood"

Treatments for aggression and agitation

How is aggression and agitation relevant to schizophrenia? Agitation and/or aggression are sometimes observed during a psychiatric emergency such as in onset of acute psychosis. Agitation typically includes irritability and restlessness, motor or verbal hyperactivity, uncooperativeness, and occasionally aggressive gestures or behaviour. This can pose a risk both to the individual, as well as the attending health care professionals, and so is important to manage this behaviour and prevent potential harm. A number of pharmacological therapies have been tested for quickly alleviating agitated or aggressive behaviour in people with schizophrenia. What is the evidence for treatments for aggression and agitation?…

Promethazine

What is promethazine? Promethazine medications are a type of sedative, in the class of antihistamine drugs. One widely known commercial promethazine is Phenergan. They work on the central nervous system, resulting in a decrease in brain cell activity. Promethazine has been used in combination with antipsychotics in situations where benzodiazepines may not be used in order to evoke sedative effects. What is the evidence for promethazine? Moderate quality evidence suggests no benefit of adjunctive promethazine over adjunctive benzodiazepines for aggression, restraint, or a need for additional medication in people with acute psychosis. There was also no benefit for service use,…

Mood stabilisers

What are mood stabilisers?  Mood stabilisers, including lithium and anticonvulsants have been proposed as an adjunctive therapy to standard antipsychotic treatments when individuals have sub-optimal responses to treatment. Mood stabilisers may be implemented as an immediate therapy for acute symptoms of psychosis, but they may also be used as part of an ongoing treatment regime. Mood stabiliser medications assessed in this topic include lithium as well as anticonvulsant medications (valproate, carbamazepine, and lamotrigine). What is the evidence for mood stabilisers? Moderate to high quality evidence suggests a small effect of adjunctive lithium for improvements in overall symptoms. Moderate quality evidence…

Benzodiazepines

What are benzodiazpines?  Benzodiazepines may be implemented as an adjunct to antipsychotic medication in order to treat acute symptoms of psychosis such as agitation, aggression, irritability, or anxiety. They may also be used to treat side effects of antipsychotic medications such as movement disorders including tardive dyskinesia, however they are associated with their own side effects and are associated with well-established patterns of tolerance and dependence, so they are prescribed with caution. What is the evidence on benzodiazepines? Moderate to low quality evidence suggests no benefit of adjunctive benzodiazepines for improving agitation or excitation in the short term (up to…

Antidepressants

How are antidepressants relevant to schizophrenia?  A supplementary, or adjunctive, treatment is administered in conjunction with a patient’s ongoing antipsychotic therapy. Antidepressants have been proposed as an additional therapy to standard antipsychotic treatments, in an attempt to improve functional outcomes and treat symptoms that are not addressed by the antipsychotic medication alone. Antidepressant medications have been studied as treatments for the symptoms of schizophrenia, particularly negative symptoms, as well as for treating people with co-occurring schizophrenia and depression. What is the evidence for adjunctive antidepressants? Moderate quality evidence finds small effects of greater improvement in overall, negative, positive, and depressive…

Depressive disorders

What are depressive disorders? Depression is characterised by a depressed mood and/or a loss of interest or pleasure in activities. Symptoms of depression include changes in appetite, weight, sleep, and psychomotor activity, decreased energy, blunted affect, social withdrawal, difficulty concentrating or making decisions, feelings of worthlessness, hopelessness and guilt, and thoughts of suicide. As many symptoms are common to both depression and the negative syndrome of schizophrenia it can be difficult to identify a comorbid depressive illness in people with schizophrenia. Identifying and treating a comorbid depressive illness may increase the likelihood of recovery from psychosis and reduce the likelihood…

Anxiety disorders

What are anxiety disorders? Anxiety disorders include generalised anxiety disorder, which is characterised by continuous and excessive worrying for six months or more. Specific phobias are characterised by anxiety provoked by a feared object/situation, resulting in avoidance. Social phobia is anxiety provoked by social or performance situations, and agoraphobia is anxiety about situations where escape may be difficult or help might not be available. Panic disorder is often the most debilitating anxiety disorder, involving recurring panic attacks which are distinct periods where a person experiences sudden apprehension and fearfulness, where they may present to services with shortness of breath, palpitations,…

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