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Objectives: This paper gives an overview of studies on the association between dopaminergic neurotransmission and the subjective experience of patients with schizophrenia.Methods: We undertook a review of the literature.Results: Dopaminergic neurotransmission may be relevant for subjective experience. Higher striatal D2 receptor occupancy by typical and atypical antipsychotics is related to worse subjective experience, more severe negative symptoms, and depression. Individuals with lower baseline dopamine function are at an increased risk for dysphoric responses during antipsychotic therapy with dopaminergic-blocking drugs. There is preliminary evidence that a window of striatal D2 receptor occupancy between 60% and 70% is optimal for the subjective experience of patients. These occupancies are often reached even with low dosages of antipsychotic drugs.Conclusions: Reaching an optimal dopamine D2 receptor occupancy is clinically relevant, since subjective experience associated with antipsychotic medication is related to medication compliance. Antipsychotic drug dosages often need to be lower than levels in common use. [ABSTRACT FROM AUTHOR]

Background: Previous evidence suggests that how an individual conceptualises the cause of a health problem can impact on subsequent perceptions and behaviour. Aims: This study explored the beliefs about the causes of psychosis in a group of mental health professionals. The study also sought to examine the relationship between causal beliefs and the perceived helpfulness of different treatments. Methods: A total of 219 clinicians completed a questionnaire about the provision of cognitive behavioural therapy (CBT) and antipsychotic medication for their clients who were experiencing psychosis and their opinions about the helpfulness of these treatments. Causal beliefs were also assessed. Results and conclusions: Clients were twice as likely to be offered medication compared to CBT. Clinicians held a multifactorial model of aetiology, but were more likely to endorse psychosocial causes than biological factors. Clinicians with psychosocial beliefs were more likely to rate CBT as effective, whereas those with biological models were more likely to endorse the helpfulness of medication. Clinicians adopt a multi-causal approach when conceptualising the aetiology of psychosis and these beliefs were related to opinions about the helpfulness of treatment. Beliefs about the aetiology of their client’s experiences could blind clinicians to the benefits of offering different approaches. [ABSTRACT FROM AUTHOR]

The article presents information on a study conducted to evaluate the efficacy of intranasal jasmine flower extract (JFE) to reduce prolactin levels of patients receiving antipsychotic drugs. In the study, an aqueous ethanol extract of jasmine flowers was used as nasal drops in 35 women. Many women showed a significant drop in the serum prolactin levels, and non-responders to JFE were on higher doses of antipsychotic drugs. The study concluded that JFE contains a prolactin-lowering substance.

The article discusses a study by Alexander P. John and colleagues which aims to determine the frequency and nature of antipsychotic polypharmacy (APP) among patients in a mental health facility in Western Australia suffering from schizophrenia and schizoaffective disorders. Topics include the methodology of the study including the definitions for data analysis of APP and antipsychotic monotherapy (APM), and the result of the study which showed elevated rates of APP.

The neutrophils of schizophrenic patients taking antipsychotic drugs were evaluated. Neutrophil immaturity was assessed by determining mean nuclear lobe number in peripheral blood smears of patients and controls. Subjects were patients medicated with typical (flupenthixol (n = 6), fluphenazine (n = 7), haloperidol (n = 23), thioridazine (n = 15), and trifluoperazine (n = 6)) or atypical (olanzapine (n = 15), risperidone (n = 10), and sulpiride (n = 7)) antipsychotic drugs. Controls (n = 58) were healthy, non-medicated clinical and academic staff. Mean robe number was determined using light microscopy and examining 300 neutrophils per individual for subject and control groups, means and medians of mean lobe numbers, and also mean white cell and neutrophil counts, were determined. Means for each group were compared using the Mann-Whitney U test; variances using F ratios. Mean lobe numbers of all patients were decreased compared to controls. The left shift occurring in patients medicated with haloperidol, olanzapine, risperidone, thioridazine, and trifluoperazine was significant at P< 0.0001; for flupenthixol P<0.001, and for sulpiride P< 0.05. The left shift for fluphenazine was not statistically significant. For one patient, mean lobe numbers were obtained before and after medication with olanzapine commenced, and a lowering of mean Lobe number was seen. Although the coefficient of variation in the patient groups was large compared to the controls, nevertheless more than half of the patients had mean lobe numbers outside the observed range of values seen in the control population. White blood cell and neutrophil counts in patients and controls were not significantly different. This study demonstrated that patients taking antipsychotic drugs have immature neutrophils, but normal total white cell and neutrophil numbers. The effect was seen with both typical and atypical antipsychotic drugs, and is probably drug-induced. It is possible that mean lobe number may predict patients at risk from neutropenia or agranulocytosis, as is also suggested by an analysis of the relative numbers of literature reports of neutrophil pathology for these drugs. It is of interest that olonzapine, which has been considered a haematologically non-hazardous drug, was shown to be associated with a significant decrease in mean lobe number. [ABSTRACT FROM AUTHOR]

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Akathisia is a syndrome of motor restlessness, principally seen in association with antipsychotic medication. It is characterized by a subjective experience of mental unease and the urge to move, and manifests physically as particular patterns of restless movement. This review focuses on the signs and symptoms of the condition, and its diagnosis and assessment using the Barnes Akathisia Rating Scale. This scale was generated 15 years ago, and was derived from the findings of studies exploring the clinical features of antipsychotic-induced akathisia. Subsequently, its validity and reliability have been established, and it has been used extensively in clinical studies worldwide. [ABSTRACT FROM AUTHOR]