A diagnosis of schizophrenia can be scary for both patients and their loved ones. A lifelong mental illness, the disease has long been associated with severe, and even terrifying, symptoms--hallucinations, delusions, increased risk of suicide. But a growing body of research is giving patients new reasons to hope.
An Improved Outlook
Although there is still no cure for schizophrenia, the outlook for patients has improved over the past 30 years, according to the National Institute of Mental Health (NIMH). These days, a treatment plan might include a combination of antipsychotic medications and cognitive behavioral therapy, family education, or other psychosocial treatments designed to improve illness-management skills. It's important to note that psychosocial treatments have been proven helpful only to schizophrenic patients who are already stabilized on antipsychotic medications.
What's more, antipsychotic drugs have evolved over the past few decades. In addition to older medications such as chlorpromazine, haloperidol, perphenazine, and fluphenzine, a new generation of drugs called atypical antipsychotics was developed in the 1990s. Atypical antipsychotics include clozapine, risperidone, olanzapine, quietiapine, sertindole, and ziprasidone. Each of these medications comes with side effects, though, and every patient responds differently. Oftentimes, several different drugs must be tried before the right treatment is found.
New Research
In the future, some experts believe that they may be able to treat or even prevent schizophrenia through a genetic on/off switch. A recent study conducted at Johns Hopkins University in Baltimore identified the mutant DISC-1 gene in a Scottish family with a strong history of schizophrenia. The researchers then developed a mouse model for the disease by inserting the gene into a normal mouse with a promoter that allowed the gene to switch on or off. They found they could turn the gene off by feeding the mice a nontoxic chemical that affects the production of DISC-1 proteins.
Another study, conducted by the NIMH and National Institute of Child Health and Human Development, found that the GAD1 gene makes an enzyme essential for production of the chemical messenger GABA. The more the gene is turned on, the more GABA synthesis can occur, under normal circumstances. GABA helps regulate the flow of electrical traffic that enables brain cells to communicate with each other and is among the major neurotransmitters in the brain.
Abnormalities in brain development and in GABA synthesis are known to play a role in schizophrenia, but the underlying molecular mechanisms are unknown. In this study, scientists discovered that defects in specific epigenetic actions--biochemical reactions that regulate gene activity, such as turning genes on and off so that they can make substances like the GAD1 enzymeare involved.
On the Horizon
The NIMH and National Institute of Child Health and Human Development discovery "opens a new area for exploration of schizophrenia," according to NIMH Director Thomas R. Insel, M.D. "Studies have yielded very strong evidence that schizophrenia involves a decrease in the enzymes, like GAD1, that help make the neurotransmitter GABA. Now we're starting to identify the mechanisms involved, and our discoveries are pointing to potential new targets for medications."
Moreover, the NIMH notes that this is an exciting time for schizophrenia research: "The explosion of knowledge in genetics, neuroscience, and behavioral research will enable a better understanding of the causes of the disorder, how to prevent it, and how to develop better treatments to allow those with schizophrenia to achieve their full potential."
