Introduction

Schizophrenia is a chronic, frequently life-time, remitting, and relapsing psychotic disorder with prominent symptoms and deficits even during phases of remission (Cancro and Lehman, 2000). Although there is a history of poor childhood and adolescent function in many patients, the illness is usually diagnosed in late adolescence or early adulthood when florid psychotic symptoms first appear. Periodic psychotic exacerbation (relapse) occurs throughout the course of the illness. Schizophrenia has devastating effects on several aspects of the patient's life and has been associated with a high risk of suicide (about 10 percent of patients die from suicide) and significant impairment in function (less than 10 percent of patients are fully employed and live independently). Its treatment requires a multimodal approach, including medication and psychosocial interventions, such as assistance with such routine demands of life as housing, financial sustenance, and personal relationships. The broad objective of treatment is to reduce

Textbook of Biological Psychiatry. Edited by Jaak Panksepp Copyright © 2004 by Wiley-Liss, Inc. ISBN: 0-471-43478-7

the overall morbidity and mortality of the disorder, decrease the frequency and severity of episodes of psychotic exacerbation, and improve the functional capacity and quality of lives of the individuals afflicted with the illness. Most patients require comprehensive and continuous care over the course of their lives. This review focuses on the pharmacological aspects of schizophrenia. The clinical and neurobiological substrates on which those treatments work are briefly reviewed.

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