BACKGROUND AND LITERATURE REVIEW
1.1: Schizophrenia and antipsychotics:
Psychosis medications are widely beneficial for treatment range of severe psychiatric disorders (Gardner et al., 2005).There are different types of psychosis for example, Schizophrenia, Affective psychosis, Substance abuse psychotic disorders and Psychosis due to medical problems(Collier Judith, Longmore Murray 2013). Schizophrenia is a common and debilitating mental disorder. It affects 24 million people globally mainly affecting young people, and it occurs in 0.1% of elderly as well(Adams et al. 2014)(Essali & Ali 2012). Various symptoms are required for the diagnosis of Schizophrenia for a period of time usually 6 months .For instance, delusions , hallucinations, speech problems ,cognitive impairment and also negative symptoms like(apathy, paucity of speech and laughing at bad news).It is important to know about both the negative and positive symptoms because different antipsychotic medications affect these symptoms differently .Schizophrenia is a chronic disease with many consequences for both the patients and their families and friends ,so effective treatment for patients and sufficient support for the caregivers are very essential parts of management of this mental disorder. There are two types of antipsychotic drugs. Typical and atypical. The decision of which one can put your patient depends on different variables like patient`s other medical conditions and presentation of Schizophrenia either acute or chronic. Typical antipsychotic like chlorpromazine acts through blocking of dopamine receptor, so as a side effect result in extrapyramidal symptoms like parkinsonism, acute dystonia, akathisia and tardive dyskinesia .In addition blockage of dopamine action results in excessive secretion of prolactin which leads to amenorrhoea, galactorrhoea and male and female infertility. This group of medications(typical antipsychotic) has little effect on negative symptoms of schizophrenia(Collier Judith, Longmore Murray 2013).
A typical antipsychotic medications are the newer form of treatment with some advantages over typical antipsychotic drugs. Extrapyramidal side effects are rare compared to the typical antipsychotic, and also less effect on prolactin level. At the same time this medication can cause sexual dysfunction like decrease lipido and erectile problems .It is also associated with cardiovascular problem like increase the risk of stoke especially with Olanzapine and risperidone(Collier Judith, Longmore Murray 2013).
Schizophrenia can lead to different kind of morbidity for the patients and the caregivers. Quality of life is disturbed in many ways. For example, cognitive impairment affects about 70-85% of patients, which results in malfunction of patients either at school or at workplace. In addition depression affects 13-80% of patients compared to general population, and the suicidal risk is twice and sometimes reaches thrice compared to general population. Family burden both physically and financially is the most essential factor to consider in treating patient with schizophrenia and about 41% of parents involved in the care of the patients……………………………………..