Schizophrenia requires lifelong treatment, even when symptoms have subsided. Treatment
with medications and psychosocial therapy can help manage the condition. In
some cases, hospitalization may be needed.
Medications are the cornerstone of
schizophrenia treatment, and antipsychotic medications are the most commonly
prescribed drugs. They're thought to control symptoms by affecting the brain
neurotransmitter dopamine.
The goal of treatment with antipsychotic medications is to effectively
manage signs and symptoms at the lowest possible dose. The
psychiatrist may try
different drugs, different doses or combinations over time to achieve the
desired result. Other medications also may help, such as antidepressants or
anti-anxiety drugs. It can take several weeks to notice an improvement in symptoms.
Because medications for schizophrenia can cause serious side effects, people with schizophrenia
may be reluctant to take them. Willingness to cooperate with treatment may affect drug
choice. For example, someone who is resistant to taking medication
consistently may need to be given
injections instead of taking a pill.
Second-generation antipsychotics
These newer, second-generation
medications are generally preferred
because they pose a lower
risk of serious side effects than do first-generation antipsychotics.
Second-generation antipsychotics include:
Aripiprazole (Abilify), Asenapine
(Saphris), Brexpiprazole (Rexulti), Cariprazine (Vraylar), Clozapine (Clozaril),
Iloperidone (Fanapt), Lurasidone (Latuda), Olanzapine (Zyprexa), Paliperidone
(Invega), Quetiapine (Seroquel), Risperidone (Risperdal), Ziprasidone (Geodon)
First-generation antipsychotics
These first-generation antipsychotics have frequent and potentially
significant neurological side effects, including the possibility of
developing a movement disorder (tardive dyskinesia) (involuntary repetitive
body movements) that may or may not be reversible. First-generation
antipsychotics include: Chlorpromazine, Fluphenazine, Haloperidol
and Perphenazine.
These antipsychotics are often cheaper than
second-generation antipsychotics, especially the generic versions, which
can be an important consideration when long-term treatment is necessary.
PSYCHOSOCIAL
INTERVENTION
Once psychosis recedes, in
addition to continuing on medication, psychological and social (psychosocial)
interventions are important. These may include:
·
Individual therapy. Psychotherapy
may help to normalize thought
patterns. Also, learning
to cope with stress and identify early warning signs of relapse can help
people with schizophrenia manage their illness.
·
Social skills training. This
focuses on improving
communication and social
interactions and improving
the ability to participate in daily activities.
·
Family therapy. This provides
support and education to families dealing with schizophrenia.
·
Vocational rehabilitation and
supported employment. This focuses on helping
people with schizophrenia prepare
for, find and keep jobs.
Most
individuals with schizophrenia require some form of daily living support. Many
communities have programs to help people with schizophrenia with jobs, housing,
self-help groups and crisis situations. A case manager or someone on the
treatment team can help find resources. With appropriate treatment, most people
with schizophrenia can manage their illness.
Hospitalization
During
crisis periods or times of severe
symptoms, hospitalization may be necessary to ensure safety, proper
nutrition, adequate sleep and basic hygiene.
Electroconvulsive therapy
For
adults with schizophrenia who
do not respond to drug therapy, electroconvulsive therapy (ECT) may be
considered. ECT may be
helpful for someone who also has depression.
SELF MANAGEMENT
Coping and support
Coping with a mental disorder as
serious as schizophrenia can be challenging, both for the person with the
condition and for friends and family. Here are some ways to cope:
·
Learn about schizophrenia. Education
about the disorder can help motivate the person with the disease to stick to
the treatment plan. Education can help friends and family understand the
disorder and be more compassionate with the person who has it.
·
Join a support group. Support
groups for people with schizophrenia can help them reach out to others facing
similar challenges. Support groups may also help family and friends cope.
·
Stay focused on goals. Managing
schizophrenia is an ongoing process. Keeping treatment goals in mind can help
the person with schizophrenia stay motivated. Help your loved one remember to
take responsibility for managing the illness and working toward goals.
·
Ask about social services
assistance. These services may be able
to assist with affordable housing, transportation and other daily activities.
·
Learn relaxation and stress
management. The person with schizophrenia
and loved ones may benefit from stress-reduction techniques such as meditation,
yoga or tai chi.
