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Current Pharmaceutical Biotechnology
ISSN (Print): 1389-2010
ISSN (Online): 1873-4316
VOLUME: 13
ISSUE: 8
DOI: 10.2174/138920112800784862      Price:  $58









Subjective Well-being of Patients with Schizophrenia as a Target of Drug Treatment

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Author(s): E. Karamatskos, C. Mulert, M. Lambert and D. Naber
Pages 1490-1499 (10)
Abstract:
An important development within the last decades is the consideration of the patient's perspective and the acknowledgement that the majority of patients are able to judge their state of well-being. Several self-report scales such as the “The Subjective Well-being under Neuroleptics Scale” (SWN) have been established. Additionally to their beneficial impact, current antipsychotics have considerable limitations. Antipsychotic-related side effects, such as extrapyramidalmotor symptoms, weight gain and obesity, apathy and anhedonia have an important influence on the patient’s wellbeing. Evidence suggests that the so-called neuroleptic-induced deficit syndrome under antipsychotics might be caused by the inhibition of the dopaminergic reward system. A reduced activation of the ventral striatum, including the nucleus accumbens is associated with negative symptom severity. Second-generation antipsychotics (henceforth SGA) block striatal D2 receptors less and show a weaker binding to D2 receptors, have interactions with several other neurotransmitters and inhibit to a lesser degree the reward functions compared to first-generation antipsychotics (henceforth FGA). This may support the reduction of negative symptoms, contributes to a higher subjective well-being, a better medication adherence and thereby an improved therapeutic outcome. The involvement of the patient and the consideration of his/her subjective wellbeing will be a major aspect in the development of new treatment strategies in schizophrenia and has a significant impact on the adherence and the long-term prognosis.
Keywords:
Schizophrenia, subjective well being, reward system, antipsychotic agents, "extrapyramidalmotor symptoms", syndrome, antipsychotics, eurotransmitters, therapeutic, long-term prognosis, treatment strategies, ventral striatum
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany.