SYMPTOMS OF SCHIZOPHRENIA

The psychological symptoms of schizophrenia are divided into three main classes: Positive, Negative & Cognitive Symptoms. While Positive & Cognitive Symptoms are almost omnipresent in schizophrenia, Positive symptoms have unrelated with cognitive symptoms. However, this relationship appeared to be accompanied by negative symptoms [8].

1. Positive Symptoms:

Positive symptoms are related with the hyperdopaminergic transmission occurring in the mesolimbic region of brain. Dopamine Receptor Antagonist drugs such as Chlorpromazine & Haloperidol are used to reduce the positive symptoms of schizophrenia [9]. It is associated with psychological behavior that is not widespread in an enthusiastic person. Suffering people may lose a touch of truth. Following some symptoms include such as delusions, hallucination, dysfunctional way of intellectual, agitated body movement, thought disorder & lack of speaking etc. [6,9].

2. Negative Symptoms:

A negative symptom indicates the abnormal normal mental function involving thoughts, behaviors & perceptions [10]. From these interruptions they can vary in general feelings and behaviors. The flat effect that the expression of emotions is reduced by facial expressions or tone of voice. Difficultly in initiating and sustaining activity and mutism (Speak Disorder) [9]. In Negative Symptoms you might notice: Anhedonia, Alogia, Flattening, Apathy, Avolition etc. [10].

3. Cognitive Symptoms:

The cognitive symptoms of schizophrenia are belongs to thinking of persons. Although cognitive symptoms aren’t used to detect schizophrenia [11]. These symptoms can vary from person to person [12]. Victims may experience normal to serious changes in their intelligence or in any other aspect of thought. Symptoms may include difficulty concentrating; memory problem, lack of execution facilities, i.e. difficulty in understanding information & making decisions [5]. In it seen some symptoms such as unable to concentrate, memory problems, reduced executive function, lack of insight etc. [11].

Causes

An exact cause of Schizophrenia is unknown. Researchers are continuously trying to find about the etiology of the disease [13] but abnormal brain structure, enter-changes in neurotransmitter functioning, genetic & environmental factors cause schizophrenia [11].

Risk Factor (Figure 1)

ANTIPSYCHOTIC

Antipsychotic is a drug which are used to treat symptoms of psychosis. They are also used to treat Schizophrenia, Depression, Bipolar disorder, Schizo affective disorders & Anxiety. Antipsychotics drugs shows adverse effect [15].

Classification of Antipsychotic Drugs

Antipsychotic drugs are classified into two subtypes such as Typical (First generation) & Atypical (Second generation). Typical medications have been used since the 1950s. It’s oldest or first type of antipsychotic drugs or medicines. Atypical medications have been used since the 1990s. It’s new or second type of antipsychotic class of drugs [16]. The use of antipsychotic drugs has the benefit of reducing the symptoms of psychosis and the risk of numerous side effects, including a difficult trade-off. Antipsychotic drugs are not therapeutic & do not eliminates long term thought disorders but they often negate the power of illusion, delusions & allow a person with schizophrenia to act in a caring situation (Figure 2) [13].

Antipsychotic medicine is a principle psychological strategy for the treatment of schizophrenia. These substances limit the effectiveness of treatment in individual patients & are associated with side effects. Taking antipsychotics is considered. While these drugs have no effect on negative symptoms. All of these drugs stop the action of postsynaptic dopamine D₂ receptors. However, modern medicine has a wide spectrum of targeted Serotonin, nor epinephrine, Acetylcholine, Histamine & Glutamate. Clozapine, considered an atypical antipsychotic, is associated with a variety of neuroreceptors (Dopamine, 5-HT serotonin & noradrenergic receptor) & and some acts as a multi-neuroreceptor antagonist. Clozapine is the most potent or highly effective antipsychotic drug & it’s does also reduce the risk of suicide of schizoaffective patients who tolerate to other antipsychotic drugs [2].

Mechanism of Action

There are many drugs used to treat schizophrenia & they have different mechanism of action to create desired therapeutic effects. Mostly antipsychotics drugs help to treat Schizophrenia [17].

1^st Generation

The first generation of antipsychotics follows inhibiting mechanism. They are highly effective when they block 72% of the D₂ dopamine receptors in the brain. They also show antagonism action at the Noradrenergic, Cholinergic & Histaminergic receptors. It’s mainly used to treat positive symptoms such as hallucinations & delusions [7,18]. In Typical antipsychotics show some adverse effect such extra-pyramidal side effects & anticholinergic adverse effect such as dry mouth, constipation etc. sedation, abnormal heart rates, sudden death, seizure threshold, hypotension, discoloration of skin, hydration, confusion, fever, acute renal failure etc. as well it’s have some contraindications like CNS depressant, cardiac abnormalities, history of allergy & seizure disorders, prostatic hypertrophy, dyskinesia, etc. [7].

2^nd Generation

The second generation of antipsychotics follows blocking mechanism. Its block the D2 dopamine receptors as well as serotonin receptors antagonist. 5-HT2A sub-type of the serotonin receptor is most commonly involved, thus may be associated with reduced risk of these adverse effect. In 2016, 12 Atypical Antipsychotics are approved by Food & Drug Administration (FDA) [7,18]. In Atypical antipsychotics show some side effects such as weight gain, metabolic syndrome development, dizziness, anxiety, sedation, thermo-sensitive, increased appetite, somnolence, hypotension, agitation, headache, restlessness, hyper salivation, etc. and it have some contraindications like parkinsonism, narcoleptic, tardive dyskinesia, during pregnancy, glaucoma, liver disease, severe neutropenia, deficiency hexosaminidase etc. [7].

TREATMENT

Antipsychotic Drugs

Physician recommended a combination of psychotic drugs along with the psychotherapy (Tables 1 & 2).

Ayurvedic Treatment

Brahmyadiyoga is an herbal preparation which is used in the treatment of Schizophrenia. Brahmyadiyoga developed by Central Council for Ayurveda & Siddha, under Ministry of Health & Family Welfare of India. It includes Brahmi, Jatamansi, Sarpagandha, Vacha, Kusta, Tagar etc. For the treatment of schizophrenia, herbal combination of water-based extract of bramhi & Jatamansi are as effective as modern antipsychotics drugs (Table 3) [6].

CONCLUSION

We concluded from this review article; schizophrenia is a complex psychiatric disorder that is belong to the disordering of brain improvement caused by environmental as well as some genetic factors. Most schizophrenia as well as psychotic disorders occurs due to abnormal brain structure & functioning. In this article we discuss about pharmacology of antipsychotics & Ayurvedic Treatment of psychosis. In that we observe delusion, hallucination, speech & behavior disorder like symptoms. In this we know about pharmacology of antipsychotics drugs but their exact causes of schizophrenia are unknown, I hope in future our researches are find exact causes of schizophrenia.

• 
  Table 1
• 
  Table 2
• 
  Table 3