Schizophrenia Hierarchal Model

Schizophrenia is a mental disorder that, when comorbid with substance abuse disorder (cocaine & alcohol abuse disorder), causes various effects on the physical and mental capacities. Schizophrenia by itself produces various effects on the physical and mental processes, so when people with Schizophrenia have comorbid substance abuse or alcohol abuse disorder they increase their chances of experiencing problems. Ziedonis & Fisher (1994) found that on average, 33% of people suffering from schizophrenia abuse cocaine. Burgemeester (2013) found that over 51 million people in the world suffer from Schizophrenia and around 2.2 million people with Schizophrenia live in the United States. According to modern statistics, Drug Abuse and Schizophrenia
Antipsychotics differ in side effects, however; these differences are the very reason why there should be a hierarchal model of some sort that can classify antipsychotic medication according to which is the most efficient. Antipsychotic medication has been separated into two categories. They are first generation antipsychotics (FGA) and second generation antipsychotics (SGA). First generation antipsychotics include the following: Chlorpromazine (Thoarzine), fluphenazine (Prolixin), haloperidol (Haldol), loxapine (Loxapine), perphenazine (Trilafon), and Thiothixene (Navane). Second generation antipsychotics include the following: Zeprasidone, Risperidone, Olanzapine, Clozapine, Aripiprazole, and Iloperidone. Classification of various antipsychotic medications into first and second generation subgroups is not adequate enough to help Schizophrenic patients with comorbid alcohol or substance abuse. Comparatively, studies have shown results that show mixed results but more studies favor second generation antipsychotics over first generation
Ultimately, Risperidone reduces the craving for cocaine and symptoms of Schizophrenia which makes risperidone suitable antipsychotic for reducing cocaine abuse and Schizophrenic symptoms. Hirose (2003) regulated a study in which he discovered that second generation antipsychotics produce subtle evidence of EPS, such as Akathisia, than first generation antipsychotics. This implies that first generation antipsychotics produce Akathisia more readily than second generation antipsychotics and it is harder to detect such subtle evidence of EPS in SGAs. Henceforth, second generation antipsychotics should be credited for producing EPS just as first generation antipsychotics despite how subtle the EPS may seem. Accordingly, one cannot say that SGAs are more efficacious than FGAs. According to a meta-analysis conducted by Leucht, Coves, Arbter, Engel, Li, and Davis (2009), they found that four out of nine second generation antipsychotics were more efficacious than first generation antipsychotics. Leucht et al also established that SGAs generate fewer EPS than first generation antipsychotics, specifically haloperidol. Although haloperidol produced more EPS than four SGAs, haloperidol has been found to produce positive effects. In reference to a study conducted by