Treatment of schizophrenia is most often pharmacological, however, patients may also be offered other therapeutic methods. The methods of treating schizophrenia include psychotherapy, but also maintaining an appropriate diet or - in rare cases - electroconvulsive therapy. There are many possibilities, but for patients with schizophrenia, the most important aspect is probably the effectiveness of treatment. So find out about the best treatments for schizophrenia and find out if the disease can be cured completely.

Treatment of schizophreniais a problem often undertaken by doctors and psychotherapists - schizophrenia is considered probably the most serious of the currently distinguished mental diseases. Indeed, patients experiencing delusions or hallucinations may arouse fear in the people around them, and due to illness in their lives may lead to various serious difficulties. The fact is that schizophrenia can be successfully treated. In the treatment of schizophrenia, not only pharmacotherapy is used, but also psychotherapy, and the condition of patients can be positively influenced by diet or adequate physical activity.

Treatment of schizophrenia: pharmacotherapy

Pharmacological treatment is the basis for the treatment of schizophrenia. This schizophrenia is most likely caused by many factors (both biological aspects and environmental factors are taken into account as the causes of this disease). One of the noticeable deviations in patients with schizophrenia is disturbances in the neurotransmitters in the nervous system, especially dopamine. It is the dopaminergic system (or more precisely, its receptors) that is influenced by the basic drugs administered to patients with schizophrenia, which are antipsychotic drugs (also called neuroleptics).

Pharmacotherapy in the treatment of schizophrenia basically consists of two stages: treatment of acute psychotic conditions and maintenance therapy. In the first of these situations, patients are given higher doses of drugs to relieve their psychotic symptoms (such as delusions or hallucinations) as quickly as possible. The condition improves at different times after the initiation of treatmentpatients - it is generally accepted that the most pronounced effects of antipsychotic treatment appear 1 to 4 weeks after starting treatment. Later, when patients' condition improves, maintenance treatment is started. It aims to maintain the mental state of patients in the best possible shape, and in addition to prevent the recurrence of psychotic symptoms.

Pharmacological treatment of schizophrenia may last even to the end of the patient's life. There is a chance that it will be possible to stop taking medication, but such a solution is only considered when the risk of exacerbation of the disease in a given patient is quite low. It is fully understandable that taking medications orally every day for several years can be simply troublesome for the patient.

Long-acting drugs in the treatment of schizophrenia

Worth knowing

Antipsychotic drugs became available in the medical world around the 1950s. It was then that classic neuroleptics (also known as 1st generation neuroleptics) were produced. These preparations work by blocking dopaminergic receptors and examples of these drugs include:

  • haloperidol,
  • chlorpromazine,
  • fluphenazine,
  • tiotiksen.

Several dozen years later, in the late 1980s, newer antipsychotics appeared on the medical market - atypical neuroleptics (second generation neuroleptics). Like the 1st generation preparations, they have the ability to block dopaminergic receptors, but they also affect serotonin receptors. Atypical neuroleptics include such agents as :

  • clozapine,
  • aripiprazole,
  • olanzapine,
  • risperidon,
  • paliperidone,
  • quetiapine.

Interestingly, antipsychotic drugs are available not only in the form of tablets - they can also be administered to patients in the form of intramuscular injections. Such an injection must be given at a specified time, depending on the specific neuroleptic being taken by the patient. In the case of an agent such as paliperidone, it may be sufficient to administer it even once every three months.

Pharmacological treatment of schizophrenia: problems and risks associated with the therapy

The basic problem related to the pharmacotherapy of schizophrenia is patients' non-compliance with medical recommendations. If we believe the disturbing statistics - up to three quarters of patients with schizophrenia opt out of pharmacological treatment. There are at least several reasons for this - some patientsThey think they don't need treatment at all, while others argue that taking medication does not improve their condition in any way.

Other patients dropped out of treatment because of the side effects of antipsychotic drugs. And they can be different - they include both slightly hindering the functioning of ailments, such as dry mouth, constipation or a slight degree of memory impairment, as well as much more serious disorders. Examples of the latter include:

  • akathisia,
  • dystonia,
  • Neuroleptic Malignant Syndrome,
  • dyskinesia,
  • hyperprolactinemia.

Most side effects occur due to treatment with classical neuroleptics, therefore these drugs are unlikely to be used as first-line agents in the treatment of schizophrenia. These disorders appear less frequently during treatment with atypical antipsychotics, however, these agents are also not without their drawbacks. In addition to the problems already mentioned, these preparations can lead to, for example, carbohydrate or lipid disorders, as well as to weight gain. In the case of one of the most commonly used neuroleptics - clozapine - there is also a risk of agranulocytosis in treated people. During antipsychotic treatment, it is also necessary to regularly check the functioning of the heart - some of the neuroleptics have the ability to prolong the QT interval, which may lead to the occurrence of dangerous arrhythmias.

Drug treatment of schizophrenia: other drugs

Although antipsychotic preparations are indeed the basic method of treating schizophrenia, other drugs are also administered to people suffering from this disease. Depending on the patients' symptoms, they may be treated with, for example, antidepressants or anti-anxiety medications.

Treatment of schizophrenia: psychotherapy

Pharmacological treatment of schizophrenia can effectively influence the productive symptoms of this disease, however, it is difficult to use drugs to influence such problems as disorganized thinking or isolation from other people (and such problems are also encountered in the course of schizophrenia). For this reason, psychotherapy is very important for patients.

Working with a psychotherapist in the case of schizophrenia can be very different. The most commonly used in patients with schizophrenia are:

  • individual therapy,
  • group therapy,
  • family therapy,
  • social skills training,
  • psychoeducation.

Usingthe aforementioned aims to help the patient find himself in the everyday world and understand his illness. Psychotherapeutic interactions may in a remarkable way improve the patient's ability to undertake professional activity or to function properly in interpersonal relationships.

Treatment of schizophrenia: when is hospitalization required?

Hospital treatment of schizophrenia may be necessary, especially in an acute episode of the disease, when the patient's psychotic symptoms are extremely severe. Admission to the hospital can take place both with the patient's consent and without their consent. The second of the above-mentioned situations may take place (in accordance with the Mental He alth Protection Act in force in Poland) when the patient threatens his own life or life or the he alth of other people.

Hospitalization may also be a good solution for people who have not been successful in their treatment so far. In a psychiatric hospital it is possible to check, for example, whether the lack of treatment effects is not due to such a trivial reason as the patient's failure to take medications. In addition, you can also - if necessary - use advanced methods of treating schizophrenia, such as, for example, electroshock.

Treatment of schizophrenia: electroshock

Electroconvulsive therapy is not among the basic therapeutic methods implemented in patients suffering from schizophrenia. Rather, electroconvulsive therapy is used only in those patients in whom the use of pharmacological treatment and psychotherapy has not led to satisfactory results. Occasionally, electroconvulsive therapy is considered in those people suffering from schizophrenia who have clearly marked (apart from schizophrenia symptoms) depressive symptoms.

Treatment of schizophrenia: the influence of diet and physical activity on the condition of patients with schizophrenia

As mentioned above, some antipsychotic drugs can cause adverse side effects, such as weight gain, carbohydrate and lipid disturbances. Due to this risk, patients with schizophrenia who use neuroleptics should be advised to choose carefully the foods they eat. Combining antipsychotic treatment with eating high-calorie, unhe althy foods can lead to even faster weight gain. Ultimately, the patient may suffer from both a mental illness and a somatic illness related to excess body weight (such as type II diabetes).

About the beneficial effects of physical activitythere is probably no need to convince anyone of the state of human he alth. Regular exercise should be recommended to patients with schizophrenia, if only because thanks to them it is possible to reduce the severity of the side effects of antipsychotic treatment in the form of excessive weight gain.

Treatment of schizophrenia: what is its effectiveness? Can schizophrenia be cured?

Patients with schizophrenia may experience difficulties in relationships with other people or have problems with taking up professional activity. However, this happens mainly when the treatment of schizophrenia is ineffective or when the patient simply neglects it. Even if it is said that schizophrenia can be cured rather than cured, treatment for this disease can really enable the patient to function normally.

Specific statistics on the effectiveness of schizophrenia treatment vary, depending on the factors that are included in the studies. According to one of the most frequently cited studies, prepared on the basis of international data, full therapeutic success can be achieved in 1/3 of all patients treated for schizophrenia. Another 1/3 of patients achieve partial but incomplete improvement, and the last part of the entire group of patients does not achieve a satisfactory improvement at all. Thus, noticeable effects of treatment can be achieved in more than half of the treated - this fact alone should convince that schizophrenia is not only necessary, but also worth treating.

ZUS spends over PLN 1 billion annually on benefits for patients with schizophrenia

ZUS spends over PLN 1 billion annually on benefits for patients with schizophrenia. A significant proportion of patients would not need to be disability pensioners and could have remained professionally active if they had received proper medical care. According to experts, the situation of patients may be improved by the greater availability of long-acting drugs and the change of the model of hospital care to community care, based on local psychiatric clinics.

Source: Biznes.newseria.pl

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

Category:

Psychiatry