These new drugs represent a significant advance, and our research efforts are going to bear significant fruition coming years. We have theories of how the drugs work, but we don't know for sure. It is unclear if prefrontal atrophy or atrophy in other areas of the brain are necessarily part of the disease process. By negative symptoms we mean social withdrawal, cognitive impairment, and similar aspects which might be related to a different chemical system than that which the old drugs treat. This is why the new, atypical, drugs really should be considered first line treatment for this illness.
Every individual case is so different.
It's important to be positive and optimistic. It is possible to continue to work and maintain social relationships, but it really will take a very comprehensive treatment plan and very supportive social supports and family and friends in order to remain that functional. Some have just a few episodes, and others seem to have one long continuous downhill course. Even the individual with just a few episodes may have a downhill course between episodes. In which their negative symptoms continue to be apparent.