Clazapine Vs Haloperidol Essay, Research Paper
Schizophrenia is a group of psychotic disorders characterized by major disturbances in thought, emotion, and behavior; disordered thinking in which ideas are not logically related; faulty perception and attention; bizarre disturbances in motor activity; flat or inappropriate emotions; and reduced tolerance for stress in interpersonal relations. The patient withdraws from people and reality, often into a fantasy life of delusions and hallucinations (Davidson, Neale 2001).
There are a number of different treatments for schizophrenia the oldest being warehousing of patients in mental hospitals in the early twentieth century where experiments like prefrontal lobotomies were being performed. This is a surgery where the tracts connecting the frontal lobes of the brain to lower centers of the brain are removed. Initial reports claimed high rates of success, and for twenty years thereafter thousands of patients underwent this procedure. In the late 1950 s this intervention fell into dispute after many patients became dull and listless and suffered many loses in their cognitive capacities, which is not surprising given the destruction of parts of the brain believed responsible for thought. There is also psychodynamic therapies were the patient is required to learn adult forms of communication and to achieve insight into the role the past has played in current problems. Social skill training is also another treatment for patients with schizophrenia. The training is designed to teach people with schizophrenia behaviors that can help them succeed in a wide variety of interpersonal situations. There is also drug therapy that without question is the most important development in the treatment of schizophrenia (Davison, Neale2001), and this is what my paper is about.
Clozapine and Haloperidol are both drugs used in the treatment of schizophrenia. Recent studies show that Clozapine has less side effects and better outcomes than Haloperidol in the treatment of schizophrenia in the areas of sexual function in schizophrenic males and females, childhood-onset schizophrenia, locomotor responses, and patient treatment.
Covington and Cola conducted a study on Clozapine versus Haloperidol: Antipsychotic effects on sexual functions in schizophrenia. They compared the effects of Clozapine and Haloperidol on the sexual function of male and female patients with schizophrenia. Before the study they reported that there was no significant difference between sexual activity of males and females prior to being diagnosed with schizophrenia. The results showed that after six months of treatment the Clozapine treated group showed greater improvement in sexual interest and activity than Clozapine treated females and Haloperidol treated males and females (Covington, Cola, 2000). In this study Clozapine out performed Haloperidol females as well as males.
In another study the National Institute of Mental Health, and Child Psychiatry Branch studied Childhood-onset schizophrenia: A double-blind Clozapine-Haloperidol comparison. They examined the efficacy and adverse effects of Clozapine and Haloperidol for children and adolescents with early-onset schizophrenia. Clozapine was shown to be superior to Haloperidol on all measures of psychosis (Kumra, etal. 1997). (Kumra, etal. 1997) concluded that Clozapine has striking superiority for positive and negative symptoms in treatment-refractory childhood-onset schizophrenia.
The VA Connecticut healthcare System sought to identify baseline predictors of differential response to Clozapine versus Haloperidol in 423 hospitalized patients with refractory schizophrenia. In the twelve month sample, patients with higher levels of symptoms had greater symptom reductions at twelve month and greater improvement of quality of life (Rosenheck, etal. 1998). Although high levels of symptoms were associated with greater improvement on Clozapine, these findings are not robust enough to suggest that any specific, clinically defined subgroup of refractory patients should be preferentially targeted for Clozapine treatment (Rosenheck, etal. 1998). Even though there wasn t a significant difference in the outcomes of the treatment of both Clozapine and Haloperidol, Clozapine continued to perform better in this study.
The effects of Kainic Acid lesions on locomotor responses to Haloperidol and Clozapine were studied by the Washington University, School of Medicine, Department of Psychiatry. They examined whether Kainic acid lesions alter the suppressive effects of the antipsychotic drugs, Haloperidol and Clozapine, on spontaneous and amphetamine-elicited locomotor behavior. (Bardgett, etal. 1998) spontaneous locomotor activity and hyperactivity elicited by amphetamine were greater in lesioned animals than controls. In addition, the level of spontaneous activity and/or amphetamine-elicited hyperlocomotion observed in lesioned rats after Haloperidol treatment was greater than that found in controls. Locomotor responses to low and moderate doses of Clozapine were similar in lesioned and control rats, although lesioned rats were more active than controls following the administration of a high dose of Clozapine. (Bardgett, etal 1998) the data collected indicated that the hyperactivity associated with Kainic acid lesions may be insensitive to reversal by Haloperidol, yet uniquely sensitive to suppression by Clozapine.
Medication continuation and compliance: A comparison of patients treated with Clozapine and Haloperidol was conducted by the VA Connecticut Health Care System. This study compares medication continuation and compliance with the atypical antipsychotic Clozapine versus Haloperidol. The data collected was from a 15-site double-blind, randomized clinical trial where military veterans with treatment-resistant schizophrenia assigned to Clozapine or Haloperidol in terms of duration of participation and the portion of prescribed pills that were taken. The relationship of baseline characteristics and measures of clinical change to continuation for the entire sample and for subjects assigned to each medication was determined. Subjects assigned to Clozapine continued taking the study drug for a mean of 35.5 weeks as compared with only 27.2 weeks among subjects assigned to Haloperidol. (Rosenheck, etal 2000) Stated among subjects assigned to Haloperidol, poorer continuation was associated with being older and greater continuation with receiving public support. Among subjects on Clozapine treatment, continuation was poorer among African Americans and greater among subjects who showed reduced symptoms and akathisia. Continuation with medication is greater with Clozapine than Haloperidol.
The comparison of Clozapine versus Haloperidol is related to Abnormal Psychology because this course focuses on Abnormal Behavior it s causes and treatments. Schizophrenia is a very abnormal and a serious disease. Schizophrenia affects many Americans and there is no known cure for schizophrenia. However treatment to suppress the symptoms associated with schizophrenia are available. Not only are Clozapine and Haloperidol related to this course any drug or medication used to treat abnormal disorders are related to this course.
I feel that Clozapine is a better prescribed medication for the treatment of schizophrenia. In this paper there are several different studies that cover several different areas in the research of both drugs. Both drugs were tested and Clozapine out performed Haloperidol in each case. (Rosenheck, etal. 2000) Continuation with medication is greater with Clozapine than Haloperidol. (Bardgett, etal 1998) These data indicate that the hyperactivity associated with Kainic acid lesions may be insensitive to reversal by Haloperidol, yet uniquely sensitive to suppression by Clozapine. (Covington, Cola 2000)Clozapine treated males maintained greater interest and activity than Clozapine treated females and Haloperidol treated males and females. (Kumra, etal. 1997) The authors concluded that Clozapine has a striking superiority for positive and negative symptoms in treatment-refractory childhood-onset schizophrenia. (Rosenheck, etal. 1998) Although high levels of symptoms were associated with greater improvement on Clozapine, these findings are not robust enough to suggest that any specific, clinically defined subgroup of refractory patients should be preferentially targeted for Clozapine treatment. In the study on quality of life there wasn t a significant difference in the two drugs, but in all accounts of the other studies Clozapine out performed Haloperidol, thus proving that Clozapine is the better drug.
Before I began researching this paper I had no idea what either drug was, nor did I have an opinion on which drug was better. Now I have a brief understanding of both drugs and some positive and negative effects of both. Clozapine did better than Haloperidol in every situation from improving quality of life in some patients, which I think, is the most important aspect in any treatment, to improving sexual function in schizophrenic patients. Even in the study on continuation of use conducted by the VA Connecticut Health Care System patients continued to take Clozapine 8 + weeks longer than patients taking Haloperidol did. If I were a psychiatrist treating a patient who was schizophrenic I would prescribe Clozapine as opposed to Haloperidol as a drug treatment for their disease.