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Treatment schizophrenia is a long and multi-stage process, since its main goal is to stop the attack psychosis(delusions, hallucinations, etc.), as well as the elimination of negative symptoms (impaired thinking, speech, emotional-volitional sphere, etc.) and the maximum full recovery normal state of a person with a return to society and family.Principles of treatment of schizophrenia
Schizophrenia is chronic mental disorder, which is completely impossible to cure, but it is quite possible to achieve a long and stable remission, during which a person will not have episodes of psychosis with hallucinations and delusions, and he will be able to work normally and be in society. It is the achievement of stable remission and the prevention of psychosis that are the main goals of treatment for schizophrenia. To achieve this goal, long-term treatment is carried out, consisting of three stages:1. Cupping therapy aimed at eliminating an episode of psychosis and suppressing productive symptoms(delusions, hallucinations, catatonia, hebephrenia, etc.);
2. Stabilizing therapy , aimed at consolidating the effect of relief treatment and completely eliminating productive symptoms;
3. Maintenance anti-relapse therapy , aimed at preventing the next psychosis or at delaying it as much as possible in time.
Curative treatment should begin before the development of complete clinical picture, already when the harbingers of psychosis appear, since in this case it will be shorter and more effective, and in addition, the severity of personality changes against the background of negative symptoms will also be minimal, which will allow the person to work or do any household chores. Hospitalization in a hospital is necessary only for the period of relief of the attack; all other stages of therapy can be carried out on an outpatient basis, that is, at home. However, if it is possible to achieve long-term remission, then once a year the person should still be hospitalized in a hospital for examination and correction of maintenance anti-relapse therapy.
After an attack of schizophrenia, treatment lasts at least a year, since it will take from 4 to 10 weeks to completely relieve psychosis, another 6 months to stabilize the achieved effect, and 5 to 8 months to form a stable remission. Therefore, close people or guardians of a patient with schizophrenia need to be mentally prepared for such long-term treatment necessary for the formation of stable remission. In the future, the patient should take medications and undergo other courses of treatment aimed at preventing another relapse of an attack of psychosis.
Schizophrenia - treatment methods (treatment methods)
The entire range of treatment methods for schizophrenia is divided into two large groups:1. Biological methods , which include all medical manipulations, procedures and medications such as:
- Taking medications that affect the central nervous system;
- Insulin comatose therapy;
- Electroconvulsive therapy;
- Lateral therapy;
- Pair polarization therapy;
- Detoxification therapy;
- Phototherapy;
- Surgical treatment (lobotomy, leucotomy);
- Sleep deprivation.
- Psychotherapy;
- Cognitive behavioral therapy;
- Family therapy.
However, despite the importance of psychosocial therapy, biological methods remain the main ones in the treatment of schizophrenia, since only they make it possible to stop psychosis, eliminate disturbances in thinking, emotions, and will, and achieve stable remission, during which a person can lead a normal life. Let us consider the characteristics, as well as the rules for the use of methods of treating schizophrenia, adopted at international congresses and recorded in the recommendations of the World Health Organization.
Currently, the most important and effective biological treatment for schizophrenia is drugs (psychopharmacology). Therefore, we will dwell on their classifications and rules of application in detail.
Modern treatment of schizophrenia during an attack
When a person begins an attack of schizophrenia (psychosis), you need to see a doctor as soon as possible, who will begin the necessary relief treatment. Currently, various drugs from the group of neuroleptics (antipsychotics) are primarily used to relieve psychosis. Most effective drugs The first line for relief therapy of schizophrenic psychosis are atypical antipsychotics, since they are able to eliminate productive symptoms (delusions and hallucinations) and, at the same time, minimize disturbances in speech, thinking, emotions, memory, will, facial expressions and behavior patterns. That is, drugs in this group can not only stop the productive symptoms of schizophrenia, but also eliminate the negative symptoms of the disease, which is very important for the rehabilitation of a person and maintaining him in a state of remission. In addition, atypical antipsychotics are effective in cases where a person cannot tolerate other antipsychotics or is resistant to their effects.
Treatment of psychotic disorder (delusions, hallucinations, illusions and other productive symptoms)
So, the treatment of a psychotic disorder (delusions, hallucinations, illusions and other productive symptoms) is carried out with atypical antipsychotics, taking into account in which clinical picture each drug is most effective. Other antipsychotic drugs are prescribed only when atypical antipsychotics are ineffective.The most powerful drug in the group is Olanzapine, which can be prescribed to all patients with schizophrenia during an attack.
Amisulpride and risperidone are most effective in suppressing delusions and hallucinations associated with depression and severe negative symptoms. Therefore, this drug is used to relieve repeated episodes of psychosis.
Quetiapine is prescribed for hallucinations and delusions, combined with speech disorders, manic behavior and severe psychomotor agitation.
If Olanzapine, Amisulpride, Risperidone or Quetiapine are ineffective, then they are replaced with conventional antipsychotics, which are effective for prolonged psychoses, as well as for poorly treatable catatonic, hebephrenic and undifferentiated forms of schizophrenia.
Majeptyl is the most effective means for catatonic and hebephrenic schizophrenia, and Trisedil for paranoid schizophrenia.
If Majeptil or Trisedil are ineffective, or the person cannot tolerate them, then conventional neuroleptics with selective action are used to relieve productive symptoms, the main representative of which is Haloperidol. Haloperidol suppresses speech hallucinations, automatisms, and all types of delusions.
Triftazin is used for unsystematic delusions associated with paranoid schizophrenia. For systematized delirium, Meterazine is used. Moditene is used for paranoid schizophrenia with severe negative symptoms (impaired speech, emotions, will, thinking).
In addition to atypical antipsychotics and conventional neuroleptics, atypical neuroleptics are used in the treatment of psychosis in schizophrenia, which in their properties occupy an intermediate position between the first two indicated groups of drugs. Currently, among the atypical antipsychotics, the most actively used are Clozapine and Piportil, which are often used as first-line drugs instead of atypical antipsychotics.
All drugs for the treatment of psychosis are used for 4 to 8 weeks, after which the person is transferred to a maintenance dosage or the drug is replaced. In addition to the main drug that relieves delusions and hallucinations, 1–2 medications can be prescribed, the action of which is aimed at suppressing psychomotor agitation.
Treatment of psychomotor agitation and reduction of emotional intensity of experiences associated with delusions and hallucinations
Treatment of psychomotor agitation and reduction of the emotional intensity of experiences associated with delusions and hallucinations should begin to give the person medications for 2 to 3 days, taking into account which manifestations predominate in the clinical picture. Thus, for psychomotor agitation, combined with anger and aggressiveness, Clopixol or Clopixol-Acupaz (a long-acting form used in people who do not want to take the medicine regularly) should be used. Also, these drugs are optimal for relieving schizophrenic psychosis in people who use alcohol or drugs, even if they are in a state of withdrawal. In cases of severe manic agitation, Quetiapine should be used.
In addition to atypical antipsychotics, they are used to relieve psychomotor agitation for 2 days. intravenous administration Diazepam in high dosages.
After relief of psychomotor agitation, Clopixol and Quetiapine are discontinued and conventional antipsychotics with a pronounced sedative effect are prescribed for 10–12 days to achieve a lasting effect of suppressing psychomotor agitation. Conventional antipsychotics are also prescribed taking into account exactly what disorders predominate in a person in the emotional-volitional sphere.
For anxiety and a state of confusion, a person is prescribed Tizercin, and for anger and aggressiveness - Aminazine. If a person has severe somatic disease or he is over 60 years old, then he is prescribed Melperon, Chlorprothixene or Propazine.
However, it should be remembered that conventional antipsychotics are prescribed only if Clopixol or Quetiapine are ineffective.
In the treatment of an attack of schizophrenia, along with the antipsychotic drugs listed above, you should use drugs that reduce the severity of emotional disorders (depression, manic behavior). To do this, depending on the exact nature of the emotional disturbances, antidepressants (thymoleptics and thymoanaleptics) and mood stabilizers are used. It is usually recommended to continue taking these drugs after the end of treatment for an attack of schizophrenia against the background of maintenance therapy, since they eliminate another range of disorders and allow you to maximally normalize a person’s quality of life.
Treatment of the depressive component in emotional disorders
The depressive component of emotional disorders should be treated with antidepressants. First of all, you should try giving the person antidepressants from the serotonin reuptake inhibitor group, such as Ixel or Venlafaxine. Moreover, Ixel is preferable in the presence of a melancholy component of depression, and Venlafaxine is preferable in cases of anxiety.In addition, Cipralex, which suppresses both the sad and anxious components of the depressive syndrome in schizophrenia, can be considered as a first-line antidepressant.
If Ixel, Venlafaxine and Cipralex are not effective, then it is recommended to use heterocyclic antidepressants, which have a more powerful effect, but are much less well tolerated, as second-line drugs in the treatment of depression. Clomipramine is effective for any component of depression - phobias, anxiety or melancholy. Amitriptyline is effective for the anxious component of depression, Melipramine is effective for the melancholy component.
Treatment of the manic component in emotional disorders
Treatment of the manic component in emotional disorders should be carried out with mood stabilizers simultaneously with antipsychotics or neuroleptics. They are used for a long time, including after the end of treatment for an attack already against the background of maintenance anti-relapse therapy.It is recommended to use Depakine and Valprocom as mood stabilizers of choice, which lead to quick elimination manic symptoms. If these drugs do not help, then lithium salts are used, which have the most powerful antimanic effect, but do not combine well with conventional antipsychotics. For mild manic symptoms, Lamotrigine is used, which is very well tolerated.
Treatment of drug-resistant psychosis
If medications are ineffective in stopping an attack of schizophrenia, when a person has resistance to them (like bacteria to antibiotics), they resort to the following methods:- Electroconvulsive therapy;
- Insulin comatose therapy;
- Craniocerebral hypothermia;
- Lateral therapy;
- Detoxification.
Electroconvulsive (electroconvulsive) therapy It is usually performed while taking antipsychotics. The course of treatment is short and is carried out using general anesthesia, which actually equates the method to surgery. Electroconvulsive therapy can be performed in two versions - bilateral or unilateral, and the second is more gentle, since it practically does not cause impairment of cognitive function (memory, attention, ability to synthesize and analyze information). Insulin comatose therapy produced against the background of the use of antipsychotics with continuous or episodic course paranoid form of schizophrenia. Absolute indication the use of insulin comatose therapy is due to intolerance or ineffectiveness of the use of drugs. Besides, this method recommended for use in case of unfavorable dynamics of schizophrenia, for example, when sensory delirium becomes interpretative, or when anxiety, absent-mindedness and mania disappear, and anger and suspicion arise instead.
Currently, insulin comatose therapy can be carried out in three modifications:
1.
Traditional modification
, which involves subcutaneous administration of insulin with a daily increase in dose up to values that will cause a coma. The method has the most pronounced effect.
2.
Forced modification
, which involves administering insulin in the form of a “dropper” continuously throughout the day so that the coma-inducing dose is reached within a day. Formed insulin comatose therapy is best tolerated.
3.
Potentiated modification
, which involves a combination of insulin administration with lateral physiotherapy (electrical stimulation of skin areas through which nerves pass to the left and right hemisphere brain). In this case, insulin is administered both traditionally and according to a structured regimen. The method allows you to maximize the effect on delusions and hallucinations, and at the same time shorten the course of treatment.
Lateral therapy It is carried out using electroanalgesia - the impact of high-frequency electric current on certain areas of the brain. The method allows you to stop psychomotor agitation, delusions, hallucinations, anxiety-depressive and manic manifestations violations emotional sphere, as well as heboid symptoms.
Detoxification is a group of methods that are used to increase sensitivity to drugs. For this, people who have allergies, complications or severe adverse reactions to antipsychotics undergo hemosorption. After several hemosorption procedures, treatment with drugs begins, which, as a rule, begin to be quite well tolerated.
In case of prolonged psychosis or severe extrapyramidal disorders (parkinsonism, impaired accuracy and coordination of movements, etc.) that have arisen against the background of long-term use of conventional antipsychotics, plasmapheresis is performed. During the course of plasmapheresis, all medications are discontinued, and at the end of the course they are prescribed again, if necessary, changing the medication or adjusting the dosage.
Stabilizing treatment for schizophrenia
After the relief of psychosis and the disappearance of delusional-hallucinatory symptoms, it is necessary to carry out stabilizing treatment for 3 to 9 months, aimed at achieving stable remission, which can last a long time. At this stage of therapy, they achieve complete suppression of residual delusional-hallucinatory symptoms, psychomotor agitation, manic or depressive components of emotional disturbances, and also try to restore the level of functioning of consciousness that the person had before the attack. To achieve this, maximum emphasis in therapy is placed on correcting the negative symptoms of schizophrenia (impaired thinking, memory, attention, apathy, lack of goals, desires and aspirations, etc.). For maintenance therapy, the drugs of choice are low-dose atypical antipsychotics such as Risperidone, Quetiapine and Amisulpride. If for some reason a person cannot take these drugs regularly and correctly, then prolonged dosage forms (Rispolept-Consta, Clopixol-Depot, Fluanxol-Depot) should be used, allowing the medicine to be given once a week.
Rispolept-Konsta is used for residual hallucinatory-delusional symptoms, as well as speech disorders.
Clopixol-Depot is used for manic and depressive symptoms, and also when hypersensitivity and excitability.
Fluanxol-Depot is optimal for symptoms of neuroses (anxiety, phobias, depersonalization, etc.).
If these drugs are ineffective, then conventional antipsychotics (Triftazine, Moditene, etc.) are prescribed. Triftazin is effective for episodic paranoid schizophrenia, Moditen-Depot is effective for residual hallucinations and delusions, as well as severe negative symptoms (impaired thinking, speech, memory, attention, will, emotions, etc.). Haloperidol is used for residual hallucinations and delusions when the attack is poorly controlled and the likelihood of sustained remission is low. Haloperidol causes extrapyramidal disorders (parkinsonism, etc.), which require the use of special drugs. Piportil is used for catatonic or paranoid schizophrenia.
Maintenance (anti-relapse) treatment of schizophrenia
Anti-relapse therapy should be carried out for 1 - 2 years after the first episode of schizophrenia, 5 years after the second and throughout life after the third, since if you stop taking antipsychotics earlier, in 75% of cases a relapse occurs after 1 - 2 years. This anti-relapse therapy involves taking antipsychotic drugs in very low dosages - no more than 20 - 30% of what was used during the attack.The main goal of anti-relapse therapy is to prevent the next attack or, if this is not possible, then to postpone it for as long as possible. In addition, during the period of remission, treatment is aimed at eliminating and correcting the negative symptoms of schizophrenia, such as impaired speech, thinking, memory, attention, a decrease in the range and depth of emotions, loss of will, etc. Correction of these disorders is necessary so that a person can again socialize and return to normal life.
Treatment with drugs
The best drugs for anti-relapse therapy are atypical antipsychotics, such as Risperidone, Quetiapine, Amisulpride. If a person is not sensitive to these drugs, then he is prescribed Sertindole. If it is impossible to ensure regular medication intake for patients with schizophrenia, long-acting dosage forms should be used, such as Rispolent-Consta, Clopixol-Depot and Fluanxol-Depot, which can be administered once a week.If atypical antipsychotics are ineffective, conventional antipsychotics should be used for anti-relapse therapy, such as Triftazin, Moditen-Depot, Haloperidol decanoate, Piportil L4.
In case of sluggish schizophrenia during the period of remission, it is recommended to use the following drugs normotimic groups:
- Depakin and Valprocom - for panic attacks and depression;
- Carbamazepine - for anger and a feeling of pain when any touch to the skin;
- Lithium salts - for depression;
- Lamotrigine - for depression, anxiety and melancholy.
Non-drug methods of anti-relapse therapy
Non-drug methods of anti-relapse therapy are as follows: - Lateral physiotherapy;
- Lateral phototherapy;
- Pair-polarized therapy;
- Transcranial micropolarization of the brain;
- Transcranial magnetic stimulation;
- Intravascular laser irradiation blood;
- Enterosorption;
- Taking immunostimulants.
Lateral phototherapy is the illumination of the left or right halves of the retina with a beam of light with an activating or, on the contrary, calming frequency. The method is very effective for neurosis-like symptoms (phobias, anxieties, fears, sensitivity disorders, excitability, etc.), as well as for mild emotional disorders.
Pair polarization therapy represents the effect of an electric field on the cerebral cortex. The method is effective for emotional disorders.
Transcranial micropolarization of the brain also represents the effect of an electric field on certain structures, which makes it possible to completely stop pseudohallucinations and residual hallucinations at the stage of remission of schizophrenia.
Transcranial magnetic stimulation represents the impact of constant magnetic field on brain structures, which allows you to effectively treat depression.
Intravascular laser irradiation of blood is used to increase a person’s sensitivity to drugs, which allows them to reduce their dosage and increase the effectiveness of therapy, achieving remission of a very high quality.
Enterosorption is a course of use of sorbent drugs, such as Polyphepan, Filtrum, Laktofiltrum, Polysorb, activated carbon, Smecta, Enterosgel, etc. Sorbents bind and remove toxic substances from the intestinal lumen, thanks to which the dosage of the antipsychotic drug can be reduced and high-quality remission achieved .
Taking immunomodulators allows you to normalize work immune system in people who have suffered an attack of schizophrenia. In addition, these drugs also improve sensitivity to neuroleptics, which makes it possible to reduce their dosage and achieve high-quality remission of long duration. The following immunomodulators are currently used:
- Echinacea and Rhodiola rosea extracts;
- Thymogen;
- Timolin;
- Erbisol;
- Sodium Nucleinate;
- Splenin;
- Villazon.
Psychosocial therapy for schizophrenia
Psychosocial therapy for schizophrenia is aimed at maximizing social and labor rehabilitation a person who has experienced an episode of psychosis. This method consists of several options for psychotherapeutic approaches to solving the personal problems of each patient with schizophrenia.Cognitive behavioral therapy is used to reduce the severity of negative symptoms (impaired thinking, memory, attention, will, emotions) and to normalize self-esteem in order to achieve a state that allows a person to work and be in society without constant fear and others. discomfort. Cognitive behavioral therapy significantly reduces the frequency of relapses of schizophrenia attacks.
This method involves cognitive training aimed at reducing the severity or completely eliminating impairments in cognitive abilities (memory, concentration, etc.). The effectiveness of the method was proven by functional magnetic resonance scanning.
Family therapy involves teaching loved ones some necessary rules of behavior after an episode of schizophrenia, as well as demonstrating to the patient his own responsibility for his life. People who have suffered an episode of schizophrenia are placed in family therapy homes where they live quite freely, as the staff explains to them the degree of responsibility for taking medications regularly, etc. The atmosphere in such homes is friendly and as open to patients as possible. In essence, this method is round-the-clock interpersonal contacts against the backdrop of a quiet, friendly, tolerant and protective environment.
Psychotherapy is carried out using different methods and is aimed at solving various internal conflicts and problems of a person so that he can, firstly, get rid of depression and neuroses, and secondly, interact normally with society.
Drugs for the treatment of schizophrenia
Drugs whose action is aimed specifically at the manifestations and causal factors schizophrenia, are various antipsychotics (also called antipsychotics). Therefore, antipsychotics are the main drugs in the treatment of schizophrenia. Currently, the following types of antipsychotics are distinguished:
- Sedative neuroleptics (in addition to the main one, they have a pronounced calming effect) - Levomepramazine (Tizercin), Chlorpromazine (Aminazine), Promazine (Propazine), Chlorprothixene (Truxal), Sultopride (Barnetil, Topral), etc.
- Incisive antipsychotics (in addition to the main one, they have an activating effect on the central nervous system) - Haloperidol (Senorm), Zuclopentixol (Klopixol, Klopixol-Depot and Klopixol-Akufaz), Hypothiazine, Thioproperazine (Mazeptil), Prochlorpyrazine, Trifluoperazine (Triftazine, Escazin), Fluphenazine (Mirenil, Moditen) and etc.
- Disturbing antipsychotics (have a disinhibiting effect on muscles) – Sulpiride (Betamax, Vero-Sulpiride, Prosulpin, Eglek, Eglonil), Carbidin.
- Atypical antipsychotics – Clozapine (Azaleprol, Azaleptin, Leponex), Olanzapine (Zalasta, Zyprexa, Egolanza), Risperidone (Neypilept, Leptinorm), Quetiapine (Quentiax, Ketilept, Quetitex, Quetiap, Cutipin, Laquel, Nantharide, Servitel, Seroquel, Victoel, Gedonin) , Amisulpride (Solian, Limipranil).
- New atypical antipsychotics – Aripiprazole (Abilify, Amdoal, Zilaxera), Ziprasidone, Sertindole (Serdolect), Ipoperidal, Blonanserin, etc.
In addition to antipsychotics in the treatment of schizophrenia, the following groups of drugs can be used to relieve various symptoms:
- Tranquilizers to relieve anxiety (Bromazepam, Phenazepam, Diazepam, Chlordiazepoxide);
- Normotimics to regulate emotions (Carbamazepine, lithium carbonate);
- Antidepressants (Amitriptyline, Moclobemide, Pirlindol);
- Nootropics to eliminate cognitive impairment (memory, attention, concentration, mental productivity) – Deanol aceglumate, Hopanthenic acid, Pantogam;
- Psychostimulants (Mesocarb).
New drugs for the treatment of schizophrenia
New drugs for the treatment of schizophrenia include all the new generation atypical antipsychotics (Aripiprazole, Ziprasidone, Sertindole, Ipoperidal and Blonanserin) and some representatives of the first generation atypical antipsychotics (Olanzapine, Risperidone, Quetiapine).These drugs do not differ in speed of onset of effect, as well as in strength of action, from typical antipsychotics, so they can be used to treat severe attacks of schizophrenia. In some cases, new drugs (Olanzapine, Risperidone) have an even stronger effect on delusional-hallucinatory symptoms than typical old antipsychotics.
An undeniable advantage of new drugs is their ability to reduce the severity of negative symptoms of schizophrenia (disorders of thinking, will, emotions) and correct cognitive impairment (disorders of memory, attention, etc.). These effects make it possible to prevent or significantly slow down a person’s disability, which allows him to interact normally with society and work for a long time.
Another advantage of new drugs for the treatment of schizophrenia is that side effects are rarer and less poorly tolerated, and do not require additional therapy.
Characteristics of some alternative treatments for schizophrenia
Let's consider brief description some methods of treating schizophrenia, which are not included in internationally approved standards, but are quite successfully used in different countries.Treatment with cytokines
Treatment of schizophrenia with cytokines is a variant of drug therapy, but the drugs used are not drugs that affect the central nervous system, but so-called cytokines. Cytokines are protein molecules that carry signals from one cell to another, thereby ensuring the coherence of the actions of the entire immune system, as well as regeneration processes in various organs, including the brain. Thanks to the effects of cytokines in the brain, the process of replacing damaged nerve cells normal. It is this effect of cytokines that is exploited in their use to treat schizophrenia. Currently, for schizophrenia, antibodies to tumor necrosis factor (anti-TNF-alpha) or interferon-gamma (anti-IFN-gamma) are administered intramuscularly. The course of treatment is 5 days, during which the drugs are administered 2 times a day.
In addition, a special solution of cytokines can be used in the form of inhalation. To do this, pour 10 ml of solution into the nebulizer for 1 inhalation and carry out the procedure every 8 hours for 3 to 5 days. In the next 5 - 10 days, inhalation is done 1 - 2 times a day. Then, for three months, 1 inhalation is given every 2 to 3 days.
Cytokine therapy for schizophrenia is used as an adjunct to antipsychotic drugs and provides better and more durable remission. The technique is used in specialized clinics in Israel and Russia.
Stem cell treatment
Treatment of schizophrenia with stem cells is a relatively new method used in complex therapy diseases. The essence of the method is the introduction of stem cells into a special structure of the brain (hippocampus), which replace defective and dead ones. As a result of such manipulation, the hippocampus begins to function normally, and schizophrenia is cured, since it is largely due to disruptions in the functioning of this particular brain structure. The introduction of stem cells is carried out only at the stage of remission of schizophrenia after the episode of psychosis has been completely stopped with neuroleptics. The use of stem cells makes it possible to achieve long-term and high-quality remission.Schizophrenia – communication treatment
Treatment of schizophrenia by communication is various methods of psychotherapy, with the help of which good contact is achieved with the patient and he is given guidelines for correct social behavior and interaction, which allows the person to feel normal in society and lead a completely fulfilling life. Treatment with communication can be carried out only during the period of remission of paranoid schizophrenia, during which there is no pronounced flattening of the personality and a sharp decrease in mental abilities. If a person has an attack of psychosis, he will first have to stop it with antipsychotics and only after that begin communication treatment under the guidance of an experienced psychotherapist or psychiatrist.
Hypnosis treatment
Treatment of schizophrenia with hypnosis is a variant of communication therapy. Its essence lies in the fact that during a hypnosis session, when a person is most easily suggestible, the psychotherapist gives him behavioral skills that help control and overcome the disease. Hypnosis can be used to treat mild paranoid schizophrenia in remission.Psychodrama and art therapy
Treatment of schizophrenia at home
Currently most In time, schizophrenia is treated at home, and only the period of the attack requires hospitalization for 4 to 6 weeks. After cupping psychotic episode a person can be discharged from the hospital provided that he has close people who can take care of him and monitor the implementation of the doctor’s orders. Treatment of schizophrenia at home is carried out with medications prescribed by a psychiatrist. At the same time, a person suffering from schizophrenia must be under the care of someone who will monitor his condition and provide doctor’s prescriptions.It is very important to record the condition of a person with schizophrenia. If a caregiver sees that he has stopped taking medications, then he should be gently and gently persuaded to visit a doctor, who can recommend long-acting forms that require taking only once a week.
When communicating with a person with schizophrenia, do not do anything that may excite him. Speak quietly, do not raise your voice, do not use commanding intonations, do not touch the person, etc. Be kind, polite, patient, tolerant and friendly. The more warmth there is in relation to a schizophrenic, the better he will be influenced.
If a person becomes irritable and begins to behave unusually, this may indicate the initial stage of an attack. In this situation, it is necessary to follow a number of rules when communicating with the patient and, as soon as possible, seek help from a psychiatrist. So, During an attack or at the beginning of its development, the following rules for communicating with a schizophrenic should be observed:
1.
Don't threaten, don't scare, and avoid any phrases that imply any adverse consequences if the person doesn't do what you want them to do (for example, if you don't eat, you'll feel bad, etc.);
2.
Do not shout, raise your voice, or add any intonation to your speech. Speak evenly, unemotionally, measuredly and quietly;
3.
Don't criticize;
4.
Don't argue with other people living nearby about what needs to be done;
5.
Don't tease a schizophrenic;
6.
Do not stand so that you are taller than the patient. If he is sitting, then you also need to sit down so that your eyes are at the same level;
7.
Don't touch the person;
8.
Do not try to constantly look into the patient's eyes;
9.
Comply with any requests of a person, if they are not dangerous for him and others;
10.
Do not lock a person in the room.
Treatment of paranoid, sluggish, fur-like and simple schizophrenia
Therapy for all of these types of schizophrenia is carried out on the basis of those described above general principles. The only difference in treatment may be specific antipsychotic drugs, selected taking into account the nature of the prevailing symptoms. In addition, depending on the severity of the disease and the extent of personality changes, non-drug therapy may be used.What is schizophrenia and how to treat it - video
Computer program for the treatment of schizophrenia - video
Treatment of schizophrenia in children
Treatment of schizophrenia in children is also carried out with antipsychotic drugs, and during periods of remission they must be used non-drug methods, aimed at maintaining normal cognitive function and eliminating disorders of thinking, emotions and will, so that the child can learn and interact with society. That is why in the treatment of schizophrenia in children, methods that eliminate the negative symptoms of schizophrenia, such as disturbances in thinking, speech, emotions and will, play a huge role. Otherwise, the principles of disease therapy in childhood the same as in adults.
Treatment prognosis
The prognosis for treatment of schizophrenia for 20 years is as follows:- In 25% of cases is happening full recovery, that is, a person lives constantly in remission, and episodes of psychosis never recur.
- In 30% of cases there is an improvement in the state in which a person can independently care for himself and exercise simple types activities. In this case, the person periodically experiences relapses of psychosis.
- In 20% of cases a person becomes helpless and needs care and guardianship. In such situations, attacks are repeated quite often and require hospitalization for a fairly long period.
In general, the prognosis for schizophrenia is more favorable the later in life the disease manifests itself. In addition, the brighter the emotional experiences during an attack, the shorter and sharper it is, and the better it responds to therapy and, accordingly, has a high probability of complete and long-term remission.
Drugs for the treatment of schizophrenia are not an abstract concept, but a list of medications that a doctor can prescribe to a patient. Basically, all remedies are aimed at eliminating specific symptoms of the disease. Naturally, the medications are selected individually by the doctor and it is he who determines the permissible dosage. Taking the drugs is long-term, and in 5 out of 10 cases it is possible to significantly improve the patient’s condition.
Before prescribing certain pills to a patient, the doctor must make a correct diagnosis. To do this, it is necessary to evaluate the symptoms. Schizophrenia has several stages of development. During an exacerbation, making a diagnosis will not cause any particular difficulties
Depending on the stage of the disease, the patient may present the following complaints:
- On bad feeling, severe headache.
- To fears and anxiety that arise for no apparent reason.
- The impossibility of completing some fantastic mission.
Patients diagnosed with schizophrenia may experience headaches, which is why people often complain of such sensations. They arise spontaneously or have a connection with some events.
Patients often say that they are worried about fears and anxiety. They are able to push dubious theories, that someone is following them or that someone is watching them. Such psychosis is considered one of the first signs of the development of a terrible disease.
A patient with schizophrenia significantly overestimates his capabilities. He can tell the doctor and orderlies that he arrived on Earth not by chance, but on some kind of secret mission. Illness makes a person think that he is great commander or the current president.
However, that’s not all, the disease is insidious. Sometimes it can be difficult to recognize. But the first thing you should pay attention to is the lack of self-criticism. A person is not able to adequately evaluate his actions and perceive the requests of others. He interprets them differently, exactly the opposite. At the same time, the patient does not understand at all what caused indignation among others.
Oddly enough, most people with this diagnosis are treated on an outpatient basis. A person can be hospitalized only in exceptional case. For example, if the disease is in the acute stage or the patient behaves inappropriately against the background of accompanying factors, creating a threat to his own life or to the health of others.
Important: outpatient treatment allows you to correct the patient’s condition and can last up to 9 months. If the patient does not feel better during this time, he is hospitalized and the therapy is adjusted.
Complex therapy is considered the most effective, starting at the initial stage of the disease. Only in this case will it be possible to achieve maximum effect. If the disease goes into remission and the person does not have a single attack of schizophrenia for 5 years, there is hope that the diagnosis will be removed.
Depending on the signs, doctors classify the symptoms of the disease. They highlight:
- Positive symptoms are signs that are unlikely to be observed in healthy people. This may include hallucinations, delusions, increased excitability, obsessive states, as well as disordered thinking.
- Positive symptoms are followed by negative ones. They are characteristic of a healthy person and are unusual for patients with schizophrenia. Negative symptoms include the absence personal qualities character. A person is not able to be responsible for his actions, he has no desire to take initiative, he does not strive for anything.
- Changes in affective nature are a number of signs that characterize the patient’s mood. These may include: apathy, depression, anxiety and suicidal thoughts or tendencies.
- But cognitive symptoms usually appear at the initial stage of the disease. It is characterized by decreased concentration and memory. The person is inattentive and reacts slowly to stimuli.
Other functions, such as motor coordination or speech, may also be affected. You should pay attention to this and consult a doctor as soon as possible, even if the patient himself reacts relatively calmly to the first signs of the disease.
If we talk about statistics on the effectiveness of drug therapy, it is worth noting that:
- 1 patient out of 10: therapy will not give any result.
- 3 out of 10 patients will benefit significantly from treatment.
- 1 – 2 patients out of 10: it will be possible to achieve stable remission with the help of medications.
As for the concept of complete cure, for many years doctors did not use it in relation to schizophrenia. Today the term “remission” is used; in essence, it means that the patient was able to completely get rid of the symptoms of the disease.
Treatment of schizophrenia
In most cases, therapy takes place in several stages and is long-term. Medicines for a disease such as schizophrenia are selected by a doctor. The dosage is also prescribed by the doctor, assessing general state patient and symptoms.
Attention! Since the disease is cyclical in nature, it is necessary to determine the stage of the disease and, based on this, prescribe adequate therapy to the patient.
To treat schizophrenia, doctors use the following classes of drugs:
- Sedatives.
- Neuroleptics.
- Antipsychotic.
Sedatives are a class of medications that are aimed at correcting a condition. They are able to remove excess nervous tension and calm a person, normalize his sleep and relieve anxiety and stress. Sedative medications cannot act as monotherapy in the treatment of schizophrenia: they are not effective enough. The most effective is complex therapy, which includes sedatives- just a component.
Neuroleptics are a class of medications that include drugs that can have different effects on the human body. They not only calm, but also help the patient not to react to external stimuli. He becomes calmer, aggression goes away, and to some extent the effect of the medications has a certain similarity to antidepressants.
Antipsychotics - that's what they're called psychotropic drugs, used in the treatment of various diseases. The action of medications is aimed at reducing positive symptoms. However, no effect of medications on negative symptoms was identified.
In certain cases, tranquilizers may be used. They have a positive effect on the patient’s condition, help to calm down and relieve tension.
As for non-drug treatment, it is widespread and is aimed at:
- working with a psychologist;
- fulfillment of communication needs;
- occupational therapy
Often, simple conversations with a doctor can affect the patient’s condition. The doctor must have experience and appropriate classification, since working with people with schizophrenia is associated with certain difficulties. This should be taken into account when conducting a session. It is important to note that classes can be of a group nature, so the patient will not only communicate with the doctor, but also fill the need for communication.
Satisfying the need for communication includes communicating with other people. It helps the patient adapt to society (a person can withdraw into himself, which is unacceptable). For this reason, you need to communicate with him, talk, walk in nature, and visit public places. Naturally, if the patient’s condition has returned to normal and he is not aggressive or prone to violence.
Working out, so-called occupational therapy, makes a person with schizophrenia feel important. Therefore, psychotherapists recommend keeping a person busy with something. This will allow him to realize certain aspirations and ambitions.
As a rule, when treating a disease, a certain regimen is followed. Therapy is aimed at:
- At the initial stage, the medicine will help relieve symptoms and get rid of the manifestations of schizophrenia. Treatment is carried out using typical antipsychotics. The doctor chooses the drug based on the patient’s condition, his ability to adequately assess himself and the manifestations of the disease. Therapy lasts from 1 to 4 months. It is based on systematically taking medications, after which time the doctor conducts comparative analysis. Medicines should eliminate the symptoms of the disease partially or completely. As a result, the patient becomes calmer, he is able to adequately assess his capabilities.
- The next stage is aimed at stabilizing the patient’s condition. Antipsychotics are used, but in smaller dosages. When taking medications, there is a decrease in the intensity of symptoms of various types. As the condition is corrected, the doctor reduces the dosage of medications. If during the treatment it is possible to get rid of the productive signs of the disease, then the therapy can be considered successful. In some cases, the medication is replaced with another, but only if necessary. The duration of therapy can range from 3 to 9 months.
- The next period in the treatment of patients with schizophrenia is adaptation. It is carried out in several stages and is protracted. Adaptation can last a year. During this time, a person must completely go through several stages: learn to communicate with people, realize himself in a particular industry. Adaptation is aimed at building social contacts; it may include group classes with a psychiatrist. During the treatment process, the patient is under the supervision of a doctor, since there is a high risk of exacerbation of the disease.
In fact, adaptation can be considered the final stage of therapy, but there is also prevention, it is based on taking medications in low dosages. Antipsychotics or other drugs may be prescribed. Prevention is needed in order to prevent a possible relapse.
Important: schizophrenia is prone to relapse, exacerbation is observed in 50% of patients. For this reason, it is so important to complete the treatment started.
It is worth noting that drug therapy has one significant disadvantage - side effects that occur in 30% of patients. They mainly consist of a depressive state that occurs during the treatment process. To correct depression, your doctor may prescribe antidepressants.
Two types of antipsychotics are used to treat schizophrenia: typical and atypical, they have different action. Typical ones have a more complete effect, while atypical ones are aimed at normalizing the production of serotonin.
Previously, only typical antipsychotics were used, although both were discovered in 1950. Atypical drugs began to be used to treat schizophrenia relatively recently, in the 1970s. For this reason, when atypical antipsychotics are prescribed, the therapy is considered experimental.
Among the antipsychotic drugs used, Haloperidol is prescribed more often than other medications. The name of the medicine and dosage will be indicated by the doctor; he will individually determine the duration of therapy and predict the result.
Drugs and side effects
For schizophrenia, pills are taken for quite a long time; some patients are forced to undergo treatment throughout their lives. In this regard, the patient may experience drug-induced parkinsonism, the main manifestations of which are considered to be restlessness, muscle stiffness, trembling, and spasms of individual muscles. To get rid of unwanted side effects, anti-parkinsonian drugs are prescribed: Diphenhydramine, Cyclodol and others.
Attention! Taking alcohol or drugs can provoke another exacerbation. To protect the patient from this, you should closely monitor him.
In most cases, for the treatment of schizophrenia, doctors prescribe:
- Azaleptin is an antipsychotic that is generally well tolerated. But if the drug was prescribed in a high dose, the risk of side effects increases. The patient may complain of dizziness, headache, drowsiness, stool or urination retention, as well as allergic reactions of various kinds.
- Haloperidol is a powerful antipsychotic, the drug is used to treat patients with schizophrenia and psychosis. "Haloperidol" is able to have a complex effect on the body. In some cases, the use medicine associated with high risk. The fact is that “Haloperidol” affects a person’s condition and can lead to a deterioration in his health, lead to suicide or cause acute extrapyramidal disorders.
- "Demanol" - nootropic drug, which stimulates brain function. It helps restore memory and normalize mental state, affects behavioral characteristics. Rarely leads to the development of side effects, but allergic reactions may occur on the skin.
- "Inveta" is an antipsychotic drug used in the treatment of children over 12 years of age. The drug is effective in therapy in children and adults, is used during exacerbations, and acts as one of the components of complex therapy. May lead to various types of side effects, starting with allergic reactions, ending with headache, nausea and other responses.
- "Lexotan" is a tranquilizer, has complex action: anxiolytic and sedative effect. Used in the treatment of various types of diseases, including mental disorders. When taking the drug, various side effects may occur: nausea, headache, insomnia, vomiting, heartburn, etc.
For this reason, taking medications should be supervised by a specialist. In some cases, if the side effects are pronounced, it is worth replacing the drug with another, but this must be done by a doctor.
Schizophrenia is usually understood as a chronic mental disease, which is manifested by an inconsistency between the thinking process and the possession of emotions. The patient does not experience impairment of consciousness, although over time the disease may progress and lead to impairments in memory, perception and thinking.
It should be noted that this disease has not been thoroughly studied. However, frequent prerequisites for the occurrence of schizophrenia are unfavorable developmental conditions in childhood, genetic predisposition, and frequent stressful situations.
Schizophrenia in psychiatry
The disease begins in adolescence or at the time of formation of an adult personality. In schizophrenia, there is an impaired perception of one's own personality. The patient is attacked by the experience that the most secret emotions, experiences and thoughts become clear to others, and they, in turn, can influence them. The disease is often accompanied by so-called positive symptoms (delusional and hallucinatory visions). This manifests itself in the form of extraneous voices. Schizophrenia, like many diseases, can have moments of exacerbation and remission.
Negative symptoms deserve special attention in this regard. Its main manifestations: prolonged apathy, loss of energy, reluctance to be in society, negative perception of the surrounding life. If you see that someone close to you is having an attack of schizophrenia, treatment should begin immediately.
Types of schizophrenia
There are simple, paranoid, residual, hebephrenic, catatonic forms of the disease.
- Simple schizophrenia characterized by positive symptoms (hallucinations). With this type, progression of certain symptoms is possible.
- Paranoid schizophrenia characterized by the appearance crazy ideas together with auditory hallucinations. There are also disturbances in the emotional-volitional sphere.
- Residual (residual) schizophrenia is a chronic manifestation of the disease, where the main symptoms are passivity, unclear speech, general lethargy, and disturbances in the emotional-volitional sphere.
- Hebephrenic form observed more often in adolescents. It manifests itself as affective disorders, defect of will, inadequate reactions to everyday things and questions, unpredictable and uncontrollable behavior, the presence of fragments of delirium and hallucinations. Against this background, negative symptoms develop very quickly.
- Catatonic schizophrenia manifested by automatic submission external factors, incomprehensible body postures. Diametrically opposite forms of impaired consciousness are noted (from obvious overexcitation to inhibition). In addition, there may be vivid visual hallucinogenic attacks.
It is important not to confuse schizophrenia with schizophreniform psychosis. The latter has a completely favorable course, although the manifestation of delusional attacks and hallucinations is possible.
There is also a schizotypal disorder, which is characterized by impaired control over emotions, violent behavior, and inconsistency in conclusions.
Schizophrenia can be effectively treated in a hospital under the supervision of qualified specialists. Therefore, it is necessary to approach the choice of a clinic and a doctor responsibly.
Diagnosis of schizophrenia
Diagnosis begins with collecting information: the patient’s complaints, studying living conditions and finding out the first manifestations of the disease, stories from the patient’s relatives and immediate circle. The psychotherapist, after a detailed study of the whole picture, assesses the mental status. This is followed by an examination by a doctor and neurological diagnostics in order to exclude other mental illnesses.
For treatment of schizophrenia in Moscow, you can contact Korsakov psychiatric clinic, where you can always count on an individual approach and competent therapy. Our specialists use effective and world-famous systems and scales to determine the severity of the disease. All procedures (diagnosis and therapy) are carried out confidentially.
To get rid of schizophrenia, pharmacopsychotherapy is chosen, which includes treatment of schizophrenia without antipsychotics to relieve symptoms. In order to maintain the effect, they resort to art therapy, psychotherapy, group and individual classes, and gestalt therapy.
Let us note that the entire range of measures is based on a humane attitude towards the patient. This means that you will not see any violence from sadistic orderlies, straitjackets and windows with bars in our clinic. Treatment is selected exclusively through an individual approach. Every day the attending physician performs an examination and briefs her on the condition and dynamics. Comprehensive care and constant supervision by medical staff contributes to a speedy recovery.
I am posting the latest research by scientists who have tested the treatment of such a condition as schizophrenia using psychological methods. Due to the fact that the material came in a closed mailing list, I will post it openly for everyone interested to see. And I’ll comment a little
Is it possible to do without pills?
They suggested treating schizophrenia without pills. Not certainly in that way. This is the title. In fact, this is just a treatment option, see below!
A study by scientists from the University of Manchester has shown that a psychological approach to the treatment of schizophrenia could be an alternative for patients who, for whatever reason, do not take medications, which, although they are first-line treatment, have serious side effects. The results of the work were published in The Lancet.
It’s clear here, this is an introduction.
Schizophrenia, which involves hallucinations, delusions, mania, paranoia, emotional problems or difficulty focusing on daily activities, affects about 60 million people worldwide.
Even if this is not a single condition/disease, but many separate ones, it is still a very global problem. Let me remind you that the risk of contracting a disease designated as schizophrenia is about 1%. And this applies to anyone! Only those who do not have sufficient intelligence do not get sick... so the percentage among smart people- somewhat higher...
John Nash - this scientist had schizophrenia and retained mental health and intelligence
In a study conducted in 14 countries in 1999, it was shown that the state of active psychosis ranks third in this regard in the world among non-physical diseases, after complete paralysis (quadriplegia) and dementia, surpassing paraplegia and blindness in its disabling impact.
However, the course of the disease shows significant diversity and is in no way associated with inevitability chronic development or progressive growth of the defect. In some cases, the frequency of which varies different cultures and populations, recovery may be complete or almost complete.
I have highlighted what is important and useful for us. There are prospects.
Currently, there are more than 20 antipsychotic drugs, such as risperidone, haloperidol and clozapine, which are effective against many symptoms of the disease, however long-term use These drugs can cause uncontrollable muscle movements, significant weight gain, or trigger a heart attack.
And I note that in many cases treatment options are limited. If there is no alternative, the risk of complications from the disease itself is high.
In recent years, more and more psychiatrists and psychologists have supported a psychological approach to treatment mental disorders, including cognitive behavioral psychotherapy (CBT), which has already shown its effectiveness in treating depression and anxiety disorders, as an adjunct to treatment with antipsychotic drugs.
Cognitive therapy is based on the premise that mental disorders are caused by dysfunctional beliefs and attitudes. This method works with conscious content and aims to directly influence the patient's cognitions (his thoughts, attitudes and expectations).
Therapy is about looking for distortions in thinking and learning an alternative, more realistic way of perceiving your life.
Here is a presentation of cognitive therapy in general, without reference to the disease being studied. Translated, this is one more thing... this is friendship! Friendship of human souls..
With schizophrenia, patients sometimes begin to conduct mental dialogues with imaginary images of people or otherworldly beings (so-called “voices”). The task of a specialist in in this case consists of explaining to a patient suffering from schizophrenia that he is not talking to real people or creatures, but with the images of these creatures created by him, thinking in turn first for himself, then for a given character.
To encourage the patient, the psychologist conveys to him the idea that mentally healthy people sometimes conduct conversations with imaginary characters, but consciously, for example, in order to predict the reaction of another person to a certain event.
And this and that and much more. People are infinitely diverse, and such specialists are infinitely diverse.
It's hard to join such a world... but you have to
A person suffering from schizophrenia may repeatedly replay a fantasy image or plot in his thoughts; gradually such fantasies are deeply recorded in the memory, enriched with realistic details and become very believable.
At the same time, there is a danger that a person will begin to confuse his fantasies with reality and may, because of this, begin to behave inappropriately, so the psychologist can try to restore in the patient’s mind real facts or events with the help of external reliable sources - documents, people whom the patient trusts, scientific literature, conversation with witnesses, photographs, videos, or the design of an experiment to test judgment.
Conditions can be very unpleasant and painful! Rational therapy, if possible, and cognitive therapy are also applicable.
Over the past few years, scientists have conducted several dozen clinical trials treatment of schizophrenia using CPT, most of which have found it to be moderately successful in reducing symptoms of the disease. The new study, led by clinical psychologist Anthony Morrison, examined the effects of cognitive therapy on 74 volunteers diagnosed with schizophrenia or schizophrenia spectrum disorder, aged 16 to 65 years.
Participants in the randomized controlled trial were divided into two groups: the first group received standard treatment, the second group received standard treatment plus a course of cognitive therapy for 18 months. Every three months, the subjects took a standard battery of tests to determine the level of their emotional experiences and social interactions.
I will note what I emphasized - volunteers! That is, people themselves agreed and/or asked that in addition to taking pills, they would also talk to them, communicate with them, take...
As research results have shown, the group of subjects who underwent cognitive therapy sessions had fewer psychotic symptoms than those in the control group. The overall effect size (a statistical measure of differences between groups) was 0.46 units on a scale in which 0.2 units is considered a low effect size, 0.5 a moderate effect size, and 0.8 a high effect size.
According to the scientists, the observed effect size is equivalent to that of most antipsychotic drugs compared to placebo.
This does not mean “replacing” drugs with psychotherapy, in my humble opinion. This means that we need to work comprehensively, and definitely include similar methods in working with patients with this disease! And not to contrast... pills and “talks”.
After all, in treatment you need to achieve the best possible result... Except for cases when pills are simply not possible, of course. You'll only have to go with the alternative.
The authors caution that despite the encouraging results, this does not mean that people with schizophrenia can stop taking their medications, as the patients in the study did not need to be hospitalized and did not pose a danger to themselves or their environment.
Yes. And it’s not even a matter of... danger to yourself or others! Simply stopping pills - without the work of psychotherapy specialists - is not a method of treatment! Well, there should be a group of specialists who can’t just “leave one to wait until he gets better.”.
However, according to statistics, up to 50% of people suffering from schizophrenia do not take antipsychotic medications for a long time. "Where possible, giving people a choice whether to take medicine or not appears to be a sensible step," Science quoted Professor Morrison as saying.
It's true. Provide a choice, but not understand this choice, hmm, in the everyday sense - “hurray, throw away the pills!”!
Each of us is a microcosm... But we have the right to intersect - and this is the basis of happiness!
And in case it is possible complex treatment- then give him the opportunity too. I note that I hardly work with people with schizophrenia. Not my specialty. But I, like other people, have to deal with related issues.
To help a “special” person, and not to ridicule him, not to spread rot on the “unusual” - this is the right of any rational being..
Schizophrenia is a chronic disease that progresses gradually. Schizophrenia must be controlled with drug therapy, especially if the disease manifests itself with acute symptoms. In Israel, psychosocial therapy is used, the basis of pharmacological therapy is antipsychotics. Atypical antipsychotics are used latest generation that do not cause side effects. The spectrum of psychotherapy techniques includes supportive psychotherapy, hydrotherapy, sports therapy, and art therapy.
What drugs do doctors use to treat schizophrenia?
Schizophrenia is mainly treated with antipsychotic medications. They, in turn, are divided into 2 groups:- atypical antipsychotics;
- conventional antipsychotics
- long-acting antipsychotics
- Risperidone (Rispolept, Risperidal, Rispaxol). The drug has a pronounced antipsychotic effect and is effective against psychotic agitation due to its sedative effect. There is a prolonged version of the drug Rispolept Konsta, administered intramuscularly once every 3-4 weeks.
- Olanzapine (Zyprexa). Can be used universally, suitable. Has a pronounced anxiolytic effect. There is a prolonged form of the drug, which is administered intramuscularly.
- Amisulpiride (Solian, Limipranil). Unlike Risperidone, it is more effective when taken less likely development of extrapyramidal symptoms. Used to relieve hallucinations.
- Sertindol (Serdolect). When used, the likelihood of weight gain is reduced; it does not provoke an increase in the levels of prolactin, cholesterol and glucose. Low likelihood of developing extrapyramidal symptoms.
- Quetiapine (Seroquel, Quetirone). According to experts, it is one of the safest in terms of side effects. Very rarely causes extrapyramidal disorders. In addition, the drug is used in the treatment of affective disorders.
- Aripiprazole (Abilify). It also has a minimal likelihood of side effects and is effective in treating any type of schizophenia.
- Asenapine (Safris). . Minimal likelihood of weight gain and sedative effects.
- Clopixol Depot, Clopixol Akufaz. A prolonged form of the antipsychotic, administered intramuscularly every 3-4 weeks.
- Invega. A metabolite of the drug Risperidone, available in tablets and injections (a prolonged form is available under the name Xeplion). Unlike Risperidone, Invega is less likely to cause anxiety and sleep disturbances.
Experts select treatment based on a number of factors. In particular, the age at which the disease was diagnosed is important. The sooner the first symptoms of the disease appear, the faster the patient can be put into remission. The nature of the course also matters - if schizophrenia occurs with acute attacks (hallucinations, disorientation, emotional swings, fears), then this form is much easier to treat than sluggish schizophrenia. Note that listed drugs belong to the group of atypical neuroleptics. In Israel, typical antipsychotics are not used due to their low effectiveness, selective action, and the high likelihood of developing neuroleptic malignant syndrome (NMS), a serious disease dangerous for life. Symptoms of NMS vary autonomic disorders, fever, muscle rigidity, mental disorders. In addition, with malignant neuroleptic syndrome chorea, tremor, dysarthria, dysphagia, epileptiform seizures, nystagmus, and loss of coordination may be observed. Among the antipsychotics that cause NMS, one can note Haloperidol, lithium preparations, Fluphenazine, Chlorpromazine (Aminazine). Drug treatment The acute phase of schizophrenia usually lasts for 1-2 months, after relief acute symptoms appoint a supportive drug therapy to maintain remission. How is schizophrenia treated?
As a rule, it is complex, using both psychosocial therapy and a number of biological techniques. The spectrum of psychosocial therapy includes cognitive behavioral therapy, family therapy and psychotherapy. Thanks to their use, it is possible to achieve stable remission and socialize the patient. Thus, the patient can take care of himself, do basic things in everyday life, and take care of personal hygiene. 
Biological treatment methods include drug therapy, psychotherapy, and supportive techniques such as occupational therapy, art therapy, sports therapy, and hydrotherapy. The greatest effect is provided by drugs for the treatment of schizophrenia - they allow you to relieve negative and positive symptoms and slow down the process of personality destruction. Are you interested in medications for the treatment of schizophrenia? Contact our specialists, we will definitely help you and your loved ones.
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