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History of Treating Schizophrenia
In the past 400 years, we’ve come a long way in how we think about and treat mental illness.
One of the most important milestones in the treatment of schizophrenia has been the recognition that mental disorders are indeed treatable illnesses—not the result of upbringing or character flaws.
Today, atypical antipsychotic medications offers people with schizophrenia more hope as they work toward their life and treatment goals.
1600s
Native American shamans, or medicine men, summoned supernatural powers to treat the mentally ill, incorporating rituals of atonement and purification.
1692
Witchcraft and demonic possession were commonly used as explanations for mental illness. The Salem witchcraft trials sentenced 19 people to hanging.
1724
Puritan clergyman Cotton Mather (1663-1728) broke with popular belief by advancing physical explanations for mental illnesses.
1812
Benjamin Rush (1745-1813) became one of the earliest advocates of humane treatment for the mentally ill with the publication of Medical Inquiries and Observations Upon Diseases of the Mind, the first American textbook of psychiatry.
1843
There were approximately 24 hospitals – totaling only 2,561 beds – available for treating mental illness in the United States.
1909
Sigmund Freud visited America and lectured on psychoanalysis at Clark University in Worcester, Massachusetts.
1920s
Harry Stack Sullivan's ward for schizophrenic patients at Sheppard-Pratt Hospital demonstrates the impact of a therapeutic milieu when patients are able to be returned to the community.
1930s
Psychiatrists began to inject insulin to induce shock and temporary coma as a treatment for schizophrenia.
1936
Egas Moniz published an account of the first human frontal lobotomy. Between 1936 and the mid-1950s, an estimated 20,000 of these surgical procedures were performed on American mental patients.
1940s
Electroconvulsant therapy (applying electric current to the brain) was first used in American hospitals to treat mental illnesses.
1947
Fountain House in NYC begins psychiatric rehabilitation for mentally ill persons.
1952
The first conventional antipsychotic drug, Thorazine® (chlorpromazine), was introduced to treat patients with schizophrenia and other major mental disorders.
1960s
Conventional antipsychotic drugs, such as haloperidol, were first used to control outward (positive) symptoms of psychosis, bringing a significant measure of calm and order to psychiatric wards.
1962
422,000 individuals were hospitalized for psychiatric care in the United States.
1970
Mass deinstitutionalization (discharge of patients from the hospital to the community) began. Patients and their families were left to their own resources due to the lack of outpatient programs for rehabilitation and reintegration back into society.
1980
Rise of managed care—short-stay hospitalization with community treatment—became the standard of care for mental illness.
1989
The first atypical antipsychotic, Clozaril® (clozapine), was introducted for patients with
treatment-resistant/intolerant schizophrenia.
1990
Researchers begin to use brain imaging to learn more about the development of major mental illnesses.
1994
A new atypical, RISPERDAL® (risperidone) becomes available in the United States.
2003
RISPERDAL® CONSTA® (risperidone) Long-Acting Injection becomes the only long-acting form of the atypical antipsychotic drugs available in the United States.
2006
A new atypical, INVEGA® (paliperidone), becomes available in the United States.
INVEGA® (paliperidone) extended-release tablets, RISPERDAL® (risperidone), and RISPERDAL® CONSTA® (risperidone) long acting injection are used for the treatment of schizophrenia.
IMPORTANT SAFETY INFORMATION FOR INVEGA, RISPERDAL, AND RISPERDAL CONSTA
Elderly Patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. INVEGA (paliperidone), RISPERDAL (risperidone), and RISPERDAL CONSTA (risperidone) are not approved for the treatment of patients with dementia-related psychosis.
Neuroleptic Malignant Syndrome (NMS) is a rare and potentially fatal side effect reported with INVEGA, RISPERDAL, RISPERDAL CONSTA, and similar medicines. Call your doctor immediately if the person being treated develops symptoms such as high fever; stiff muscles; shaking; confusion; sweating; changes in pulse, heart rate, or blood pressure; or muscle pain and weakness. Treatment should be stopped if the person being treated has NMS.
One risk of INVEGA is that it may change your heart rhythm. This effect is potentially serious, and you should talk to your doctor about any current or past heart problems. Some medications interact with INVEGA. Please inform your healthcare professional of any medications or supplements that you are taking.
Tardive Dyskinesia (TD) is a serious, sometimes permanent side effect reported with INVEGA, RISPERDAL, RISPERDAL CONSTA, and similar medications. TD includes uncontrollable movements of the face, tongue, and other parts of the body. The risk of developing TD and the chance that it will become permanent is thought to increase with the length of therapy and the overall dose taken by the patient. This condition can develop after a brief period of therapy at low doses, although this is much less common. There is no known treatment for TD, but it may go away partially or completely if therapy is stopped.
High blood sugar and diabetes have been reported with INVEGA, RISPERDAL, RISPERDAL CONSTA, and similar medications. If the person being treated has diabetes or risk factors such as being overweight or a family history of diabetes, blood sugar testing should be performed at the beginning and throughout treatment. Complications of diabetes can be serious and even life threatening. If signs of high blood sugar or diabetes develop, such as being thirsty all the time, going to the bathroom a lot, or feeling weak or hungry, contact your doctor.
INVEGA, RISPERDAL, RISPERDAL CONSTA, and similar medications can raise blood levels of a hormone known as prolactin, causing a condition known as hyperprolactinemia. Blood levels of prolactin remain elevated with continued use. Some side effects seen with these medications include the absence of a menstrual period; breasts producing milk; the development of breasts by males; and the inability to achieve an erection. The connection between prolactin levels and side effects is unknown.
People with narrowing or blockage of the gastrointestinal tract (esophagus, stomach or small or large intestine) should talk to their healthcare professional before taking INVEGA.
Some people taking INVEGA, RISPERDAL, or RISPERDAL CONSTA may feel faint or lightheaded when they stand up or sit up too quickly. By standing up or sitting up slowly and following your healthcare professional's dosing instructions, this side effect may be reduced or it may go away over time.
INVEGA, RISPERDAL, and RISPERDAL CONSTA may affect your driving ability; therefore, do not drive or operate machinery before talking to your healthcare professional. Avoid alcohol while taking these drugs.
INVEGA, RISPERDAL, and RISPERDAL CONSTA should be used cautiously in people with a seizure disorder, who have had seizures in the past, or who have conditions that increase their risk for seizures.
Extrapyramidal Symptoms (EPS) are usually persistent movement disorders or muscle disturbances, such as restlessness, tremors, and muscle stiffness. If you observe any of these symptoms, talk to your healthcare professional.
Inform your healthcare professional if you are pregnant or if you are planning to get pregnant while taking INVEGA, RISPERDAL, or RISPERDAL CONSTA. Caution should be used when administering to a nursing woman.
INVEGA, RISPERDAL, and RISPERDAL CONSTA may affect alertness and motor skills; use caution until this effect is known.
INVEGA may make you more sensitive to heat. You may have trouble cooling off, or be more likely to become dehydrated, so take care when exercising or when doing things that make you warm.
Some medications interact with INVEGA, RISPERDAL, or RISPERDAL CONSTA. Please inform your healthcare professional of any medications or supplements that you are taking. Avoid alcohol while on INVEGA, RISPERDAL, or RISPERDAL CONSTA.
INVEGA should be swallowed whole. Tablets should not be chewed, divided, or crushed. Do not be worried if you see something that looks like a tablet in your stool. This is what is left of the tablet after all the medicine has been released.
In a study of people taking INVEGA, the most common side effects in the treatment of schizophrenia were restlessness and extra pyramidal disorder (for example, involuntary movements, tremors and muscle stiffness).
The most common adverse reactions observed in all clinical trials with RISPERDAL occurring at a rate of at least 10% were somnolence, increased appetite, fatigue, rhinitis, upper respiratory tract infection, vomiting, coughing, urinary incontinence, increased saliva, constipation, fever, tremors, muscle stiffness, abdominal pain, anxiety, nausea, dizziness, dry mouth, rash, restlessness, and indigestion.
In a study of people taking RISPERDAL CONSTA, the most common side effects in the treatment of schizophrenia were anxiety, sleepiness, restlessness, tremors, muscle stiffness, dizziness, constipation, nausea, stomach upset, runny nose, dry mouth, rash, weight increase, and rapid heartbeat.
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Please see the Important Product Information for INVEGA, RISPERDAL and RISPERDAL CONSTA.
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This page was last modified on: Jul 27 2007 at 10:44:16 EDT