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By Melissa Tennen, HealthAtoZ writer
They said she would die. If she stepped out of that cab, left her seat on the airplane or walked out of the house, death would sweep her away. So said these voices that only she could hear.
Elaine Mullins, 53, has schizophrenia, a chronic and terrifying brain disease.
In her darkest times, she couldn't even dress or bathe herself and had to be institutionalized. And not a single medication could quiet the cacophony.
But one day the voices hushed, and suddenly there was Elaine - the old Elaine.
"I bought a vehicle, I go to church, I clean my apartment, I do my laundry.... I'm so happy. I thank the Lord every night. My life has just changed 100 percent. The drug is a godsend," she says.
For two years, Mullins has been taking aripiprazole (Abilify®), a drug that helps control some of her more debilitating symptoms of schizophrenia, such as hallucinations and paranoia.
Schizophrenia does not mean a death sentence, and it does not mean you have lost the person you love. That person is still there, underneath the symptoms of the disease. With help from medications and counseling, those symptoms can be controlled entirely or partially, helping people have a good quality of life.
Aripiprazole is a part of the new generation (also called atypical) antipsychotics that treat both positive and negative symptoms of schizophrenia, often with fewer side effects.
Affecting 2.2 million adult Americans, schizophrenia is a devastating disease that usually develops in the teen years or early 20s. The illness interferes with a person's ability to think clearly, tell the difference between reality and fantasy, make decisions, and have relationships. Although there is no cure, the disease is treatable. Scientists can't say what specifically causes the disorder, but they do know that defects in the brain either chemical or structural probably play a role in the disorder. Genes may be a factor in making someone more vulnerable.
Many symptoms of schizophrenia exist and categorized as "positive", "disorganized" and "negative":
Positive: These include delusions and hallucinations that develop because of the break with reality. Delusions mean the person is thinking others are plotting against them, secretly monitoring them, threatening them or trying to control their minds. Hallucinations mean the person is seeing or hearing things that aren't there. Disorganized: Confused thinking, speech and behavior that doesn't make sense. They may not be speaking clearly or have trouble making sense of the world. Negative: These symptoms refer to characteristics that should be there but aren't such as emotion and expression. They may lack pleasure in life. The person is less able to feel emotions, including pain and joy.
Medications that treat the disorder are called antipsychotics. Older medications were introduced in the 1950s and helped with the positive symptoms. These include chlorpromazine (Thorazine®), fluphenazine (Prolixin®), haloperidol (Haldol®), thiothixene (Navane®), trifluoperazine (Stelazine®) perphenazine (Trilafon®) and thioridazine (Mellaril®).
Newer antipsychotics called new atypical antipsychotics, or second generation antipsychotics, were introduced in the last decade. These may treat both positive and negative symptoms, but seem more effective than older antipsychotics at reducing the negative symptoms such as withdrawal and lack of energy. Medications in this class include: risperidone (Risperdal®), clozapine (Clozaril®), olanzapine (Zyprexa®) quetiapine (Seroquel®), aripiprazole (Abilify®) and ziprasidone (Geodon®).
 Recent research has shown an increased risk of diabetes associated with newer antipsychotics. The Food and Drug Administration asked manufacturers of these drugs to insert warnings in the prescribing information materials. Contact your doctor if you have questions.
All medications have side effects, and antipsychotics are no different. They can be mild such as a dry mouth, blurred vision, constipation, drowsiness and dizziness. Or the side effects could cause trouble with muscle control and walking, or tremors and facial tics. A serious problem is tardive dyskinesia where there are uncontrolled facial movements and sometimes jerking or twisting of other body parts. This can develop after several years of taking these medications. However, medication can help people control their symptoms and lead fulfilling lives.
"While we're still not at one point where there is a cure for schizophrenia, these medications can really change someone's life from never-ending symptoms to getting well enough to have a real life," said Peter Weiden, M.D., director of the Schizophrenia Research Program of the SUNY Downstate Medical Center Brooklyn in New York.
Each person responds differently to medications, depending on body chemistry and the severity of the illness. These medications help improve some symptoms enough to help people with the disease function better in society.
"[Aripiprazole has] been the only thing to help her," says Jenifer Rhoades, Elaine's 27-year-old daughter. "We've gone from her crawling around on the floor - growling and talking to pictures - to living by herself."
This article was reviewed and updated June 2007.
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