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Long-Term Treatment Goals: Enhancing Healthy Outcomes

Published online by Cambridge University Press:  07 November 2014

Abstract

The long-term management of schizophrenia with a goal of functional rehabilitation remains an enormous challenge to clinicians despite improvements in drug therapy, psychosocial treatments, and family and community interventions. The goals of long-term therapy are to preserve the gains made during acute treatment, prevent symptom exacerbation, enhance psychosocial functioning, and improve quality of life. Schizophrenia is an illness that disrupts broad areas of mental function, including thought, cognition, affect, and motor performance. The new antipsychotics should aid physicians in meeting higher treatment goals for persons with schizophrenia. These agents combine high efficacy with improved tolerability, mainly through a low liability for extrapyramidal symptoms and probably improve cognitive affect. Recent studies have demonstrated efficacy of these new antipsychotics in improving psychopathology and symptoms and in preventing relapse during long-term use. These drugs are likely to provide physicians with an increasingly viable option in the long-term treatment and rehabilitation of patients with schizophrenia.

Type
Academic Supplement
Copyright
Copyright © Cambridge University Press 2003

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References

REFERENCES

1.Redelmeier, DA, Tan, SH, Booth, GL. The treatment of unrelated disorders in patients with chronic medical diseases. N Engl J Med. 1998;338:15161520.CrossRefGoogle ScholarPubMed
2.Tollefson, GD, Sanger, TM, Lu, Y, Thieme, ME. Depressive signs and symptoms in schizophrenia: a prospective blinded trial of olanzapine and haloperidol. Arch Gen Psychiatry. 1998;55:250258.CrossRefGoogle ScholarPubMed
3.Hirsch, SR, Kissling, W, Bauml, J, Power, A, O'Connor, R. A 28-week comparison of ziprasidone and haloperidol in outpatients with stable schizophrenia. J Clin Psychiatry. 2002;63:516523.CrossRefGoogle ScholarPubMed
4.Tandon, R, Jibson, MD. Efficacy of newer generation antipsychotics in the treatment of schizophrenia. Psychoneuroendocrinology. 2003;28(suppl 1):926.CrossRefGoogle ScholarPubMed
5.Tran, PV, Dellva, MA, Tollefson, GD, Wentley, AL, Beasley, CM Jr.Oral olanzapine versus oral haloperidol in the maintenance treatment of schizophrenia and related psychoses. Br J Psychiatry. 1998;172:499505.CrossRefGoogle ScholarPubMed
6.Arató, M, O'Connor, R, Meltzer, HY, ZEUS Study Group. A 1-year, double-blind, placebo-controlled trial of ziprasidone 40, 80 and 160 mg/day in chronic schizophrenia: the Ziprasidone Extended Use in Schizophrenia (ZEUS) study. Int Clin Psychopharmacol. 2002;17:207215.CrossRefGoogle Scholar
7.Csernansky, JG, Mahmoud, R, Brenner, R, Risperidone-USA-79 Study Group. A comparison of risperidone and haloperidol for the prevention of relapse in patients with schizophrenia. N Engl J Med. 2002;346:1622.CrossRefGoogle Scholar
8.Newman, SC, Bland, RC. Mortality in a cohort of patients with schizophrenia: a record linkage study. Can J Psychiatry. 1991;36:239245.CrossRefGoogle Scholar
9.Harris, EC, Barraclough, B. Excess mortality of mental disorder. Br J Psychiatry. 1998;173:1153.CrossRefGoogle ScholarPubMed
10.Brown, S, Inskip, H, Barraclough, B. Causes of excess mortality of schizophrenia. Br J Psychiatry. 2000;177:212217.CrossRefGoogle ScholarPubMed
11.Ösby, U, Correia, N, Brandt, L, Ekbom, A, Sparen, P. Mortality and causes of death in schizophrenia in Stockholm county, Sweden. Schizophr Res. 2000;45:2128.CrossRefGoogle ScholarPubMed
12.Coodin, S. Body mass index in persons with schizophrenia. Can J Psychiatry. 2001;46:549555.CrossRefGoogle ScholarPubMed
13.Mukherjee, S, Decina, P, Bocola, V, Saraceni, F, Scapicchio, PL. Diabetes mellitus in schizophrenic patients. Compr Psychiatry. 1996;37:6873.CrossRefGoogle ScholarPubMed
14.Harris, MI, Flegal, KM, Cowie, CC, et al.Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care. 1998;21:518524.CrossRefGoogle ScholarPubMed
15.de Leon, J, Dadvand, M, Canuso, C, White, AO, Stanilla, JK. Simpson, CM. Schizophrenia and smoking: an epidemiological survey in a state hospital. Am J Psychiatry. 1995;152:453455.Google ScholarPubMed
16.Brown, S, Birtwistle, J, Roe, L, Thompson, C. The unhealthy lifestyle of people with schizophrenia. Psychol Med. 1999;29:697701.CrossRefGoogle ScholarPubMed
17.David, SR, Taylor, CC, Kinon, BJ, Breier, A. The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia. Clin Ther. 2000;22:10851096.CrossRefGoogle ScholarPubMed
18.Casey, DE, Carson, WH, Saha, AR, et al.Switching patients to aripiprazole from other antipsychotic agents: a multicenter randomized study. Psychopharmacology (Berl). 2003;166:391399.CrossRefGoogle ScholarPubMed
19.Allison, DB, Mentore, JL, Heo, M, et al.Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999;156:16861696.CrossRefGoogle ScholarPubMed
20.Kane, JM, Carson, WH, Saha, AR, et al.Efficacy and safety of aripiprazole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry. 2002;63:763771.CrossRefGoogle ScholarPubMed
21.Sernyak, MJ, Leslie, DL, Alarcon, RD, Losonczy, MF, Rosenheck, R. Association of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophrenia. Am J Psychiatry. 2002;159:561566.CrossRefGoogle ScholarPubMed
22.Glick, ID, Romano, SJ, Simpson, G, et al. Insulin resistance in olanzapine- and ziprasidone-treated patients: results of a double-blind, controlled 6-week trial. Poster presented at: 154th Annual Meeting of the American Psychiatric Association; May 7-11, 2001; New Orleans, La.Google Scholar
23.Naidoo, U, Goff, DC, Klibanski, A. Hyperprolactinemia and bone mineral density: the potential impact of antipsychotic agents. Psychoneuroendocrinology. 2003;28(suppl 2):97108.CrossRefGoogle ScholarPubMed
24.Domon, SE, Webber, JC. Hyperglycemia and hypertriglyceridemia secondary to olanzapine. J Child Adolesc Psychopharmacol. 2001;11:285288.CrossRefGoogle ScholarPubMed
25.Meyer, JM. A retrospective comparison of weight, lipid, and glucose changes between risperidone- and olanzapine-treated inpatients: metabolic outcomes after 1 year. J Clin Psychiatry. 2002;63:425433.CrossRefGoogle ScholarPubMed
26.Atmaca, M, Kuloglu, M, Tezcan, E, Ustundag, B. Serum leptin and triglyceride levels in patients on treatment with atypical antipsychotics. J Clin Psychiatry. 2003;64:598604.CrossRefGoogle ScholarPubMed
27.Wilson, PW, D'Agostino, RB, Levy, D, Belanger, AM, Silbershatz, H, Kannel, WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:18371847.CrossRefGoogle ScholarPubMed