Treatment of Schizophrenia

cont. from

Self-Care at Home

Home care for a person with schizophrenia depends on how ill the person is and on the family or guardian's ability to care for the person. The ability to care for a person with schizophrenia is tied closely to time, emotional strength, and financial reserves.

In spite of these possible barriers, basic issues to address with people with schizophrenia, include the following:

• First, ensure that your loved one is taking prescribed medications. One of the most common reasons that people with schizophrenia relapse into a new episode is that they quit taking medication. Family members might see much improvement and mistakenly assume medications may no longer be needed. That is a disastrous assumption. A later psychotic outbreak will likely happen.
• The family should provide a caring, safe environment that allows for as much freedom of action as is appropriate at the time. Any hostility in the environment should be reduced or eliminated. Likewise, any criticism should be reduced.

Medical Treatment

This is a time of hope for people with schizophrenia as well as for their families. New and safer medications are constantly being discovered, thus making it possible not only to treat symptoms otherwise resistant to treatment (such as negative or cognitive symptoms), but to considerably diminish the side-effect burden and to improve the quality and enjoyment of life.

In patients experiencing acutely psychotic episodes in which they are obviously a danger to themselves and others, due to either suicidal or homicidal ideation, or inability to take care of their basic needs, hospitalization and antipsychotic medications are the treatments of choice. Hospitalization is essential.

Medications for Schizophrenia

Antipsychotic medications are proven effective in treating acute psychosis and reducing the risk of future psychotic episodes. The treatment of schizophrenia thus has two main phases: an acute phase, when higher doses might be necessary in order to treat psychotic symptoms, followed by a maintenance phase, which could be life-long. During the maintenance phase, dosage is gradually reduced to the minimum required to prevent further episodes. If symptoms reappear on a lower dosage, a temporary increase in dosage may help prevent a relapse.

Even with continued treatment, some patients experience relapses. By far, though, the highest relapse rates are seen when medication is discontinued.

The large majority of patients experience substantial improvement when treated with antipsychotic agents. Some patients, however, do not respond to medications, and a few may seem not to need them.

Since it is difficult to predict which patients will fall into what groups, it is essential to have long-term follow-up, so that the treatment can be adjusted and any problems addressed promptly.

Antipsychotic medications are the cornerstone in the management of schizophrenia. They have been available since the mid-1950s, and although antipsychotics do not cure the illness, they greatly reduce the symptoms and allow the patient to function better, have better quality of life, and enjoy an improved outlook. The choice and dosage of medication is individualized and is best done by a physician who is well trained and experienced in treating severe mental illness.

continue: Atypical Antipsychotics

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Reviewed: 03/2006