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  Mens Sana Monographs
A Monograph Series Devoted To The Understanding Of Medicine, Mental Health, Man, Mind, Music And Their Matrix
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Year : 2012  |  Volume : 10  |  Issue : 1  |  Page : 4-12

Psychopharmacology of schizophrenia: The future looks bleak

1 M.D. Professor and Head, Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore-560 029, India
2 M.D. Postdoctoral Associate, Dept of Psychiatry, Yale University School of Medicine, New Haven, CT- 06511, USA
3 M.D. Associate Professor of Psychiatry, Department of Psychiatry, Creighton University School of Medicine, 3528 Dodge Street, Omaha, NE 68131, USA

Correspondence Address:
Chittaranjan Andrade
M.D. (Psychiatry), Professor and Head, Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore 560 029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1229.91293

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Introduction: More than half a century after the introduction of effective pharmacotherapy for the illness, in most patients schizophrenia remains a chronic, relapsing condition with poor long-term outcomes. Methods: We examine the pharmacological treatment of schizophrenia from different perspectives to understand why there have not been significant advances, and to consider what the future might hold in store. Results: We argue that the treatment of schizophrenia addresses the phenotype and not the cause; that the causes may not be treatable even if identifiable; that secondary prevention approaches involving treating the phenotype before full-fledged illness develops have, so far, not yielded promising results; and that shifting the focus of treatment from dopamine to other neurotransmitter systems is merely a tertiary prevention approach which will not reverse the extensive structural and functional pathology of schizophrenia. Conclusions: We believe that, given the current state of our knowledge of the illness, the future of the pharmacotherapy of schizophrenia looks bleak.

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