A brief history of drug development for patients with schizophrenia: toward improving their potential in rehabilitation

Background: Schizophrenia is one of the most disabling diseases with remarkable functional loss. Drug treatment is still the mainstay in managing patients with schizophrenia. In this article, the author intends to briefly recount a history of the drug development in the treatment for the patients with schizophrenia, and to suggest short list of most suitable drugs for them. Methods: The author comprehensively reviewed the benefits and side effects of all available drugs for treating patients with schizophrenia. Focuses are on drugs with least potential of producing liability of extra-pyramidal symptoms (EPS), and those with mild side effect of weight gain. Results: The drugs for treating patients with schizophrenia were originally targeting at improving positive symptoms of schizophrenia. Those dopamine antagonists (such as chlorpromazine, haloperidol, etc.) improve disorganized behaviors, hallucinations, delusion, and looseness of association effectively but produce unbearable EPS. Recent drugs (mixed receptor antagonists, serotonin-dopamine antagonists, patial dopamine and serotonin agonists) can improve positive, negative symptoms with least EPS but produce body weight gain and other metabolic side effects. Some recently introduced new drugs (such as amisulpride, lurasidone, lumateperone, aripriprozole, brexpiprazole and cariprazine) have least liability of causing EPS but with mild side effect on weight gain (less than 1 kg during the treatment course for an episode of acute exacerbation in patients with schizophrenia). But patients’ cognitive improvement from drugs for treating patients with schizophrenia and comorbid depressive symptom are still often overlooked. Conclusion: Clinicians prescribe drugs with minimal EPS and mild weight gain for patients with schizophrenia, and pay attention to minimalize patients’ cognitive impairment and to treat comorbid depression. Then, patients with schizophrenia can expand new better potentials and opportunities for occupational rehabilitation.REVIEW ARTICLEothe

Rehabilitative and habilitative perspectives of exercise in treating major depressive disorder

Background: Major depressive disorder (MDD) is a most frequently occurred neuropsychiatric condition. About 25% of the female and 12% of the male in the population suffer from MDD at least one time in their lifetime. The treatment with currently available antidepressants are mostly effectively. Among other benefits to the health, exercise has been found to have therapeutic effect on improving MDD, and preventing from a new-onset MDD. But those benefits are often overlooked by psychiatrists, non-psychiatrist physicians, physical therapists, speech therapists, and occupational therapists. Methods: Besides my lifetime experiences of living my life, receiving training, teaching, and practicing psychiatry, I also collected information from published papers pertinent to beneficial issue related to exercise for patients with MDD in this review. Results: In this review, I have highlighted some important information that exercise helps in improving patients with MDD, and in preventing a new onset episode of MDD. Discussion: To keep the readership for rehabilitation therapists to be in mind, the author discusses the issue of exercise in the rehabilitative and habilitative perspectives in MDD treatment and prevention of future occurrence of MDD. Therefore, I also recommend that all patients with MDD are encouraged to start with a lifestyle of more physical activities and routine exercise.Review Articleothe

How can rehabilitation specialists write high-quality scientific English papers?

[Objectives:] The objectives of this review are to familiarize rehabilitation specialists or students with rules of effective English-writing and to improve the writing quality of their rehabilitation papers for scientific publication. [Method:] Based on the format of author's monograph Examples in Writing English Medical Papers for the 21st Century, I compiled examples of scientific writings. Those examples were mainly adapted over the years from past pre-submitted manuscripts to the program of young doctors' development at Taipei Medical University-Wan Fang Medical Center, requesting for the service of copy-editing before manuscript were submitted to journals for consideration for publication. Some of them were from submitted manuscripts to the Taiwanese Journal of Psychiatry (www.e-tjp.org). [Results:] For clear, effective English-writing, I introduce briefly in this article the rules of 10 do's and don'ts (using correct grammar, writing simpler sentences, varying writing styles, using more active voice writing, avoiding redundancies, reducing the use of Latinate words, choosing strong verbs, using correct parallel construction, avoiding empty words or phrases, and choosing correct specific words). Then, I show the actual hands-on copy-edited changes of sample sentences from original versions to revisions in writing the introduction, methods, results, discussion, and abstract sections of manuscripts. I also explain and illustrated in those sampled rehabilitation writings. [Conclusion:] I hope that the rehabilitation specialists and students can have some ideas how to write and improve high-quality English papers in their future preparation of scientific rehabilitation manuscripts after your reading this article carefully.Review Articleothe