Schizophrenia

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A. Presentation

[symptoms and signs]

B. Investigation

[investigative/screening tests/algorithms]

C. Treatment

[treatment principles/general measures/medication regimes]

Atypical anti-psychotics:

Risperidone – 5-HT antagonist. SE: extrapyramidal adverse effects (in particular akathisia). Some weight gain, hyperprolactinemia. Patients switching from traditional antipsychotics may undergo cholinergic rebound (influenza-like symptoms). (First line drug)

Olanzapine – SE: drowsiness, weight gain, and dizziness. Temporary liver enzyme increases.

Quetiapine – Low potency, low risk of extrapyramidal adverse effects. SE: dizziness, dry mouth, and hypotension

Clozapine – SE: 2~3% neutropenia, 1% agranulocytosis, sedation, hypersalivation, weight gain, severe constipation, myoclonus and epileptic seizures. (Last line)

ECT can be used for psychotic depression when the patient fails to respond to pharmacotherapy.

D. Other notes

[epidemilogy/risk factors/
causes/mechanisms/compications/ddx/
classification/staging/
followups/prognosis/prognostic factors/prevention]