Joe Mullich
Freelance Health Writer
818-907-9109
New Jersey Monthly
At Last, Silencing the Voices
By Joe Mullich
It sounds like a scene from the movie "Awakenings." A man who had been confined to a Texas state mental hospital for 36 years with schizophrenia came home for the holidays this past Christmas. His friends and family had long ago forsaken the man as lost in the twilight existance of schizophrenia, but that was before the advent of a remarkable drug called Clozaril that was developed by Sandoz Pharmaceutical in East Hanover, NJ. Now, the man no longer heard the voices or hallucinations that had haunted him for three decades.
This story is not fiction, nor is it uncommon. Last year, 175 people attended a "prom" at Case Western Reserve University in Cleveland, celebrating their "awakening," thanks to Clozaril, after years of suffering from schizophrenia. Why a prom? The 175 participants had never attended a real one--many couldn't remember anything about their young adult lives.
New Jersey has been the scene of millions of medical miracles. Headquartered here are some of the health care industry's top companies and research centers, staffed by first-rate scientists who work with cutting-edge technology. Almost daily, these highly-trained men and women push back the boundaries of medicine in order to create drugs, therapies and devices that can change the way we live.
Take "Bill" for example. (Bill and his family asked that we not use their real names.) Bill suffers from schizophrenia, a devastating, incurable mental illness that affects some 2.5 million people. For years, Bill's family had carted him off to doctors around the country. He had 60 electro-shock treatments. He tried every new drug. Nothing worked. Bill seemed destined to spend his life in a locked mental ward of a New Jersey hospital, hearing the voices, being unable to concentrate on anything or respond to anyone.
For years, starting when he was a teenager, Bill heard grotesque voice, talking to him inside his head. Over and over, the voices said, "Hurt yourself. Kill yourself."
But then Bill was given Clozaril and within a matter of months the symptoms began to diminish. Today, if you sat next to Bill at a restaurant, you would never imagine the anguish he suffered for years. "It is," says Bill's father, "nothing short of a miracle."
Approved by the FDA two years ago, Clozaril has shown great success in helping up to two-thirds of the thousands who, like Bill, are resistant to other treatments. Older anti-psychotic drugs like Thorazine relieve the hallucinations in 60 to 70 percent of schizophrenia cases, though the drugs are less effective in treating other symptoms, such as lack of energy or withdrawal.
The cause of schizophrenia, and the bizarre behavior it spurs, are not known. Like most people with schizophrenia, Bill developed the disease in his late teens. Until then he was an avid tennis player and an outstanding prep school student who planned to eventually enter the family business. "He had everything going for him," says Bill's father. "People don't understand that schizophrenia is like cancer. The brain is a part of the body and, like any other part of the body, it can become ill."
As with many other pharmacological treatments, no one is exactly sure how Clozaril relieves the symptoms of schizophrenia. Researchers believe the drug blocks excessive flows of serotonin and dopamine, natural chemicals that help brain cells communicate with each other. Patients take two to three Clozaril tablets daily. For those who respond to the drug, improvement is usually seen in six weeks to six months.
The drug is not without risk. Some patients develop seizures. About 2 percent of patients suffer from agranulocytosis, a potentially-fatal decrease in white blood cells that fight infections. For this reason, patients who take Clozaril must also submit to weekly blood tests to detect early signs of agranulocytosis. In addition, Clozaril is expensive, costing more than $4,000 a year.
Despite possible complications, researchers say the drug therapy is unparallel in its ability to treat this mental illness. "The field of pharmacology had written off a great subgroup of people with schizophrenia," says Dr. Gilbert Honigfeld, director of scientific affairs for Sandoz Pharmaceuticals. "They felt these people were beyond the reach of contemporary medicine. This has introduced a new element of hope, rejuvenated this field of research and many more medicines are to come."
Schizophrenia research has become such a hot topic that promising drugs from two other New Jersey companies--Johnson & Johnson and Merck & Co.--are in the late stages of development. "There is so much new hope," says Dr. Honigfeld. "And in the next decade there will be even more." (continued)