Trip to Perdition- Schizophrenia & Brain Chemistry

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The chemical Dopamine acts in the brain's reward centers. In a normal functioning brain, pleasure and happiness results from its release. In a schizophrenic brain, the overproduction of dopamine, leads to auditory hallucinations and frightening images in the afflicted. Image by John A Jaksich

The chemical Dopamine acts in the brain’s reward centers. In a normal functioning brain, pleasure and happiness result from its release. In a schizophrenic brain, the overproduction of dopamine leads to auditory hallucinations and frightening, visual hallucinations in the afflicted. Image by John A Jaksich

The grip of Schizophrenia upon the afflicted is described as a trip to perdition-also known as the road to hell. The World Health Organization (WHO) estimates that 21 million people world wide have the disease. The Centers for Disease Control in the US (CDC) estimates 50 percent of those with schizophrenia commit suicide. For the others, the illness leaves them confused and emotionally scarred. Medical professionals have compared schizophrenia to being high on PCP (Angel Dust). And, much like the illicit drug trade, Schizophrenia crisscrosses through all of current society.

What Is Schizophrenia?

Schizophrenia manifests itself in the late teens with hallucinations-voices and horrifying images. While the eventual manifestation can be traced to the early teen years, the last symptoms (evidenced in adulthood) are affected by lifestyle (living conditions).

According to the Schizophrenia Working Group Consortium, there are presently 108 sites upon the genetic code that may be ultimately responsible for symptoms that cripple and mentally maim the afflicted. Because all genetic aspects are not pinned down, what researchers know comes from painstaking autopsies, animal models, Magnetic Resonance Images of the affected brains and the observation of the effects of medications upon the ill.

Researchers have found that the brain structures of these individuals possess incomplete neural connections. This incomplete brain connectivity causes the ill to experience a range of symptoms: from hallucinations and poor thought organization to a lack of emotional expression and  depression. Perhaps, the symptoms may be seen as the mind attempting to put together meanings to fragmented thoughts.

Neurochemistry: How does Schizophrenia Originate?

Neurochemistry of schizophrenia is a cauldron of reactions that cannot be isolated in any one center within the brain. The brain of an ill person with schizophrenia looks superficially similar to that of a “healthy” person. However, the chemicals that normally produce coherent thoughts can not do so – the sites in the brain needed to finish a coherent thought are not present. The incomplete brain structure has been altered by a complex set of genetics- that is presently described as non-Mendelian. Non-Mendelian implies other circumstances beyond inheritability from both parents.

NMDA

Glutamate is implicated in NMDA receptors for symptoms of schizophrenia. Copyright image by John A. Jaksich. All rights reserved.

Of the one hundred and eight genetic sites (previously mentioned) what is clear is the gestation time frames of mothers of the afflicted experienced stresses to their bodies. Other problems (in the afflicted) such as drug abuse or child abuse have factored in as well. In cases of identical twins- if one has schizophrenia, then there is approximately a 50 percent chance that both will be afflicted with the illness, according to the WHO. However, this number is presently being reconsidered. In research performed by multiple groups, schizophrenia strikes those who are genetically predisposed for it, and environmental (chemical or biological) factors seem to play a much larger role.

The associated neurochemistries of Schizophrenia, at first manifestations, flood dopamine around the dopaminergic receptors and the extra dopamine is bound to ‘foreign’ neuroreceptors – this causes the afflicted individual to hear voices and experience visual hallucinations. Once the hallucinations recede through treatment with medications such as Thorazine, Haldol or an atypical medication such as Risperdal, the illness still progresses.

Most treatment regimens are hard pressed to alleviate symptoms such as ‘flat, expressionless, emotional states.’ The neurochemistries associated with flat emotions correspond to glutamate functions in the brain. The primary receptor associated with glutamate function is known as the NMDA receptor-it has a long history of investigation. The administration of glycine and serine (amino acids) affect NMDA receptors and other regions of the brain, as well. However, poor penetration past the Blood Brain Barrier of the amino acids has proved to be a daunting area of research. Neurochemists and medicinal chemists continue to experiment in this area.

Can We Chemically and Physically Describe Schizophrenia?

A brain affected with Schizophrenia has three generalized symptoms: psychosis, a loss of emotion, and reduction in cognitive abilities (lower IQ). Psychiatrists term these as ‘Positive, Negative, and Cognitive.’ The terms correlate to a positive or over-production of Dopamine, an absence of Glutamate function and problems with thought organization. However, all result from brain structures with neurochemical imbalances. The onset of Schizophrenia produces an excess of dopamine in the regions of the brain that can not handle the excess- leading to the hallucinations. In addition, when compared to the general population, the ill have less brain mass and volume.

The Possibility of Hope?

Treatment orthodoxies for Schizophrenia have changed in the past decade. However, psychiatrists, mental health professionals, and medical researchers are pursuing a multitude of strategies. One strategy is to identify individuals with the potential for schizophrenia; the hope is to identify potential biomarkers. Biomarkers are characteristic biochemicals that can be identified at treatment and disease junctures. Once biomarkers are identified in a disease, doctors may find it easier to treat the afflicted and implement preventative measures.

The extent and depth of hallucinations is a key to how the illness progresses. Understanding potential biomarkers in the future, in the disease of schizophrenia, offers the hope of a better outcome.

Schizophrenia: Disease of the Brain

Schizophrenia is a disease of the brain. Present treatment procedures need to concentrate on preventative measures for those at risk. The drug pipeline for Schizophrenia is almost bare; however, finding potential biomarkers is a step in the positive direction to alleviating the suffering of the afflicted.

For some, the descent to hallucinations and incapacitation becomes a long and lonely journey. This life journey may be marked by hospitalizations and suicide attempts. The trip is not for the meek.

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