Over the past years, there has been no significant progress in scientific research on schizophrenia, a disease that recently made its way back to the news in France, following the murder of a nurse by a psychopath, but new molecules may be driving the slump.
And the Scottish psychiatrist Robin Murray, who devoted decades of his life to research on this disease, told the French Press Agency that “pharmacological treatments have not changed radically” in this field over twenty or thirty years.
In France, this serious psychological disorder was highlighted, following a knife attack that killed a nurse a few days ago in the French city of Reims, at the hands of a person suffering from schizophrenia. It is feared that such incidents may place a negative stigma on all patients.
“All the work that has been done over the years to try to destigmatize this disease fell in 24 hours,” psychiatrist Sonia Dollfuss told AFP, stressing the “extremely rare” nature of this work.
For most schizophrenics, estimated by the World Health Organization to account for one in 300 people worldwide, the disease represents a danger first and foremost for those affected, especially because of the high rate of suicides among them (about 5 percent).
On a larger scale, schizophrenia, which results in a wide range of disorders of varying severity from one patient to another, often leads to profound disruption of personal and social life.
Treatment for this disease is also complex, and generally combines medication, assistance with social reintegration, and psychotherapy.
On this last level, follow-up has improved in recent decades, says Murray, who notes a decrease in psychoanalytic treatments considered ineffective or even counterproductive for such psychotic disorders.
On the other hand, in the medical field, the situation has remained largely the same for several years. However, unlike other mental disorders, particularly neurotic disorders, medication remains the cornerstone of psychotherapy for schizophrenia.
Dollfuss said, “After a vacuum starting in the second decade of the current century, when laboratories actually stopped their investments in psychiatry, a real innovation trend is currently being recorded.”
At the present stage, tangible innovations relate to the follow-up of patients, for example through the development of computer applications that facilitate contact with the psychiatrist, and the method of taking the already known medications.
Thus, in April, the US health authorities approved a treatment developed by the Israeli company “Teva” and the French “Medensil”. The molecule, originally known to psychiatrists, will be administered by injection, not by mouth. Thus, the drug can be gradually released into the body over a period of weeks, rather than requiring daily intake.
The challenge is to allow for better monitoring of medications when many patients, due to their disorders, have to stop taking regular medication. According to various sources, this was the case with the Reims attacker.
Although this is a promising advance at the therapeutic level, we cannot talk about a revolution associated, for example, with the emergence of new molecules. But in this area, too, progress finally seems possible.
“The drugs that are being explored are really interesting because of their new mechanisms of action,” Dollfuss explains.
The molecules currently used in schizophrenia basically boil down to one mode of action: they block the action of dopamine, a molecule that has a central effect on the nervous system.
However, dopamine appears to play a complex role in schizophrenia, whether it is excessive at some levels or insufficient at others, and these treatments, which are very effective against symptoms such as hallucinations, do not improve other aspects of the disease, such as loss of will or language.
In the face of this observation, research has finally focused on other molecules, whose mode of action is broader by regulating dopamine transmission rather than inhibiting it, while acting in parallel with other molecules potentially implicated in schizophrenia disorders.
Research on these therapies that specifically target a protein called TAAR1 is at an advanced stage, as large-scale, so-called Phase III studies are beginning to report good results. “It’s a really promising path,” Dollfuss concludes.
2023-05-28 10:02:54
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