Schizophrenia: Not Just One Disease

We could save more than 1,000 lives in Ohio just by improving prescribing practices for schizophrenia.  

That was one of the compelling messages delivered by Erik Messamore, M.D., Ph.D., associate professor of psychiatry at NEOMED, in a recent Grand Rounds presentation for health care professionals at Cleveland Clinic Akron General.

As the medical director of NEOMED’s Best Practices in Schizophrenia Treatment (BeST) Center, Dr. Messamore serves as an advocate for improved identification and treatment of schizophrenia. He is particularly interested in raising awareness of the efficacy of Clozapine—a medication that is not often enough prescribed, considering that it is by far the most effective antipsychotic drug for the disease, said Dr. Messamore.

In his lecture, titled “Listening to Clozapine: The Case for Numerous, Physiologically Distinct Schizophrenias,” Dr. Messamore also made the case for thinking about schizophrenia as a set of symptoms that come from a variety of different causes. Some cases are related to dopamine, others to high levels of glutamate (a factor in memory processing). By thinking as a pharmacologist—his own training—Dr. Messamore says that physicians can better identify the most helpful medication.

If you give a dopamine receptor blocker to a patient and they don’t get better, the evidence suggests it’s a different type of schizophrenia, says Dr. Messamore. Increasing the dosage won’t help if different medication is needed.

Promising Developments

Recent developments in genetic testing are opening doors to more detailed understanding of schizophrenia as a disease, Dr. Messamore says. People found to have elevated dopamine biomarkers in their blood are likely to respond well to dopamine-blocking medication, for example.  

The BeST Center offers a full array of services to help community agencies implement and sustain treatment practices that improve the lives of people affected by schizophrenia. To learn more, contact BeST Center Director Patrice M. Fetzer, LISW-S, at or 330.325.6695.

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