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Treatments for Schizophrenia

Treatments for Schizophrenia:

The overall treatment goal for schizophrenia is to minimize symptoms so that people with the disorder can live as functional, independent, and productive lives as possible. There is no cure for schizophrenia, but consistent ongoing compliance with a multifaceted treatment program can often effectively control symptoms and prevent relapses of acute episodes of symptoms. To be most effective, treatment may need to be life-long. Treatment includes medications, psychotherapy, and rehabilitation.

Medications used to treat schizophrenia are called antipsychotics. Older types of antipsychotics include Stellazine and Thorazine. These drugs are very effective in reducing hallucinations and delusions and preventing relapses of symptoms. However, they can have serious neurological side effects, which may discourage compliance with their use. New types of antipsychotic drugs, such as Abilify and Zyprexa, can reduce even more symptoms than older types of drugs and they have far fewer serious side effects. However, they still may have some side effects that are bothersome.

At some time during their treatment, some people with schizophrenia may erroneously believe that no longer need medication and stop taking it. It is very important for people taking antipsychotics to take exactly as directed. Changes in doses or discontinuation of medications can result in an acute relapse of symptoms. Ongoing outpatient psychiatric and medical care is important to help monitor the effectiveness of treatment and to assess for side effects and appropriate doses of medications.

Another facet of treatment for schizophrenia is psychotherapy, commonly known as "talk therapy". In psychotherapy, a psychotherapist builds a relationship with a client, establishing trust and helping the client better cope with schizophrenia and to understand the factors that can worsen the effects of schizophrenia. Rehabilitation programs are available to help people with schizophrenia to function as independently and normally as possible in everyday life.

In an acute episode of schizophrenia, symptoms may be so serious that a person is unable to safely care for basic needs and/or has become suicidal or a danger to himself or herself or others. Treatment requires inpatient care. In some cases a person may need to be legally hospitalized against their will for their own safety.

Treatment List for Schizophrenia

The list of treatments mentioned in various sources for Schizophrenia includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Schizophrenia: Is the Diagnosis Correct?

The first step in getting correct treatment is to get a correct diagnosis. Differential diagnosis list for Schizophrenia may include:

Hidden causes of Schizophrenia may be incorrectly diagnosed:

  • Hereditary is a significant risk factor for schizophrenia and there have been a number of genes which have been linked to a susceptibility for developing schizophrenia. A genetic risk coupled with an environmental trigger are considered the main cause of schizophrenia by many experts. There also appears to be a link between maternal genital or reproductive infection at the time of conception to an increased risk of developing schizophrenia in the baby
  • more causes...»

Schizophrenia: Marketplace Products, Discounts & Offers

Products, offers and promotion categories available for Schizophrenia:

Curable Types of Schizophrenia

Possibly curable types of Schizophrenia may include:

  • HIV infection related schizophrenia
  • Systemic infection related schizophrenia
  • Epilepsy related schizophrenia
  • Syphilis related schizophrenia
  • more curable types...»

Schizophrenia: Research Doctors & Specialists

Research all specialists including ratings, affiliations, and sanctions.

Drugs and Medications used to treat Schizophrenia:

Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment or change in treatment plans.

Some of the different medications used in the treatment of Schizophrenia include:

Unlabeled Drugs and Medications to treat Schizophrenia:

Unlabelled alternative drug treatments for Schizophrenia include:

  • Carbamazepine
  • Apo-Carbamazepine
  • Carbitrol Extended Release
  • Domcarbamazepine-CR
  • Epitol
  • Gen-Carbamazepine CR
  • Mazepine
  • Novo-Carbamaz
  • PMS Carbamazepine
  • Taro-carbamazepine CR
  • Tegretol
  • Tegretol Chewable Tablet
  • Tegretol-CR
  • Tegretol-XR
  • Imipramine
  • Antipress
  • Apo-Imipramine
  • Impril
  • Imprin
  • Janimine
  • Novo-Pramine
  • PMS Imipramine
  • Presamoine
  • SK-Pramine
  • Tipramine
  • Tofranil
  • Tofranil-PM
  • W.D.D
  • Ondansetron
  • Zofran
  • Zofran ODT
  • Zofran Oral Solution
  • Alti-Clonazepam
  • Clonapam
  • Gen-Clonazepam
  • Nu-Clonazepam
  • PMS-Clonazepam
  • Rho-Clonazepam
  • Kenoket

Hospital statistics for Schizophrenia:

These medical statistics relate to hospitals, hospitalization and Schizophrenia:

  • schizophrenia resulted in 17,731 hospitalisations in Australia 2001-02 (AIHW Hospital Morbidity Database 2001-02, Australia’s Health 2004, AIHW)
  • schizophrenia accounted for 237,174 patient days in hospitals in Australia 2001-02 (AIHW Hospital Morbidity Database 2001-02, Australia’s Health 2004, AIHW)
  • 0.3% (37,736) of hospital episodes were for schizophrenia, schizotypal and delusional disorders in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 88% of hospital consultations for schizophrenia, schizotypal and delusional disorders required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • more hospital information...»

Hospitals & Medical Clinics: Schizophrenia

Research quality ratings and patient incidents/safety measures for hospitals and medical facilities in specialties related to Schizophrenia:

Hospital & Clinic quality ratings »

Choosing the Best Treatment Hospital: More general information, not necessarily in relation to Schizophrenia, on hospital and medical facility performance and surgical care quality:

Medical news summaries about treatments for Schizophrenia:

The following medical news items are relevant to treatment of Schizophrenia:

Discussion of treatments for Schizophrenia:

Medications: NIMH (Excerpt)

There are a number of antipsychotic (neuroleptic) medications available. These medications affect neurotransmitters that allow communication between nerve cells. One such neurotransmitter, dopamine, is thought to be relevant to schizophrenia symptoms. All these medications have been shown to be effective for schizophrenia. The main differences are in the potency--that is, the dosage (amount) prescribed to produce therapeutic effects-and the side effects. Some people might think that the higher the dose of medication prescribed, the more serious the illness; but this is not always true. (Source: excerpt from Medications: NIMH)

Medications: NIMH (Excerpt)

The 1990s saw the development of several new drugs for schizophrenia, called "atypical antipsychotics." Because they have fewer side effects than the older drugs, today they are often used as a first-line treatment. The first atypical antipsychotic, clozapine (Clozaril), was introduced in the United States in 1990. In clinical trials, this medication was found to be more effective than conventional or "typical" antipsychotic medications in individuals with treatment-resistant schizophrenia (schizophrenia that has not responded to other drugs), and the risk of tardive dyskinesia (a movement disorder) was lower. However, because of the potential side effect of a serious blood disorder--agranulocytosis (loss of the white blood cells that fight infection)-patients who are on clozapine must have a blood test every 1 or 2 weeks. The inconvenience and cost of blood tests and the medication itself have made maintenance on clozapine difficult for many people. Clozapine, however, continues to be the drug of choice for treatment-resistant schizophrenia patients.

Several other atypical antipsychotics have been developed since clozapine was introduced. The first was risperidone (Risperdal), followed by olanzapine (Zyprexa), quetiapine (Seroquel), and ziprasidone (Geodon). Each has a unique side effect profile, but in general, these medications are better tolerated than the earlier drugs.

All these medications have their place in the treatment of schizophrenia, and doctors will choose among them. They will consider the person's symptoms, age, weight, and personal and family medication history. (Source: excerpt from Medications: NIMH)

Medications: NIMH (Excerpt)

Long-term treatment of schizophrenia with one of the older, or "conventional," antipsychotics may cause a person to develop tardive dyskinesia (TD). Tardive dyskinesia is a condition characterized by involuntary movements, most often around the mouth. It may range from mild to severe. In some people, it cannot be reversed, while others recover partially or completely. Tardive dyskinesia is sometimes seen in people with schizophrenia who have never been treated with an antipsychotic medication; this is called "spontaneous dyskinesia."1 However, it is most often seen after long-term treatment with older antipsychotic medications. The risk has been reduced with the newer "atypical" medications. There is a higher incidence in women, and the risk rises with age. The possible risks of long-term treatment with an antipsychotic medication must be weighed against the benefits in each case. The risk for TD is 5 percent per year with older medications; it is less with the newer medications. (Source: excerpt from Medications: NIMH)

Schizophrenia Research at the NIMH: NIMH (Excerpt)

Thanks to NIMH research, a number of new antipsychotic drugs, "atypical antipsychotics," have been introduced since 1990. The first, clozapine (Clozaril®), is more effective than older antipsychotics, although it has possible severe side effects, such as agranulocytosis-- a loss of white blood cells that fight infection -- that require patients to be frequently monitored with blood tests. The newer atypical medications, such as risperidone (Risperdal®), quetiapine (Seroquel®), and olanzapine (Zyprexa®), are safer than the older drugs or clozapine and have fewer side effects, so they may be better tolerated by patients. NIMH is supporting clinical trials to further understand the role of atypical antipsychotics in treating schizophrenia. (Source: excerpt from Schizophrenia Research at the NIMH: NIMH)

Schizophrenia: NIMH (Excerpt)

Since schizophrenia may not be a single condition and its causes are not yet known, current treatment methods are based on both clinical research and experience. These approaches are chosen on the basis of their ability to reduce the symptoms of schizophrenia and to lessen the chances that symptoms will return.

What About Medications?

Antipsychotic medications have been available since the mid-1950s. They have greatly improved the outlook for individual patients. These medications reduce the psychotic symptoms of schizophrenia and usually allow the patient to function more effectively and appropriately. Antipsychotic drugs are the best treatment now available, but they do not “cure” schizophrenia or ensure that there will be no further psychotic episodes. The choice and dosage of medication can be made only by a qualified physician who is well trained in the medical treatment of mental disorders. The dosage of medication is individualized for each patient, since people may vary a great deal in the amount of drug needed to reduce symptoms without producing troublesome side effects.

The large majority of people with schizophrenia show substantial improvement when treated with antipsychotic drugs. Some patients, however, are not helped very much by the medications and a few do not seem to need them. It is difficult to predict which patients will fall into these two groups and to distinguish them from the large majority of patients who do benefit from treatment with antipsychotic drugs.

A number of new antipsychotic drugs (the so-called “atypical antipsychotics”) have been introduced since 1990. The first of these, clozapine (Clozaril®), has been shown to be more effective than other antipsychotics, although the possibility of severe side effects – in particular, a condition called agranulocytosis (loss of the white blood cells that fight infection) – requires that patients be monitored with blood tests every one or two weeks. Even newer antipsychotic drugs, such as risperidone (Risperdal®) and olanzapine (Zyprexa®), are safer than the older drugs or clozapine, and they also may be better tolerated. They may or may not treat the illness as well as clozapine, however. Several additional antipsychotics are currently under development.

Antipsychotic drugs are often very effective in treating certain symptoms of schizophrenia, particularly hallucinations and delusions; unfortunately, the drugs may not be as helpful with other symptoms, such as reduced motivation and emotional expressiveness. Indeed, the older antipsychotics (which also went by the name of “neuroleptics”), medicines like haloperidol (Haldol®) or chlorpromazine (Thorazine®), may even produce side effects that resemble the more difficult to treat symptoms. Often, lowering the dose or switching to a different medicine may reduce these side effects; the newer medicines, including olanzapine (Zyprexa®), quetiapine (Seroquel®), and risperidone (Risperdal®), appear less likely to have this problem. Sometimes when people with schizophrenia become depressed, other symptoms can appear to worsen. The symptoms may improve with the addition of an antidepressant medication.

Patients and families sometimes become worried about the antipsychotic medications used to treat schizophrenia. In addition to concern about side effects, they may worry that such drugs could lead to addiction. However, antipsychotic medications do not produce a “high” (euphoria) or addictive behavior in people who take them.

Another misconception about antipsychotic drugs is that they act as a kind of mind control, or a “chemical straitjacket.” Antipsychotic drugs used at the appropriate dosage do not “knock out” people or take away their free will. While these medications can be sedating, and while this effect can be useful when treatment is initiated particularly if an individual is quite agitated, the utility of the drugs is not due to sedation but to their ability to diminish the hallucinations, agitation, confusion, and delusions of a psychotic episode. Thus, antipsychotic medications should eventually help an individual with schizophrenia to deal with the world more rationally.

How Long Should People With Schizophrenia Take Antipsychotic Drugs?

Antipsychotic medications reduce the risk of future psychotic episodes in patients who have recovered from an acute episode. Even with continued drug treatment, some people who have recovered will suffer relapses. Far higher relapse rates are seen when medication is discontinued. In most cases, it would not be accurate to say that continued drug treatment “prevents” relapses; rather, it reduces their intensity and frequency. The treatment of severe psychotic symptoms generally requires higher dosages than those used for maintenance treatment. If symptoms reappear on a lower dosage, a temporary increase in dosage may prevent a full-blown relapse.

Because relapse of illness is more likely when antipsychotic medications are discontinued or taken irregularly, it is very important that people with schizophrenia work with their doctors and family members to adhere to their treatment plan. Adherence to treatment refers to the degree to which patients follow the treatment plans recommended by their doctors. Good adherence involves taking prescribed medication at the correct dose and proper times each day, attending clinic appointments, and/or carefully following other treatment procedures. Treatment adherence is often difficult for people with schizophrenia, but it can be made easier with the help of several strategies and can lead to improved quality of life.

There are a variety of reasons why people with schizophrenia may not adhere to treatment. Patients may not believe they are ill and may deny the need for medication, or they may have such disorganized thinking that they cannot remember to take their daily doses. Family members or friends may not understand schizophrenia and may inappropriately advise the person with schizophrenia to stop treatment when he or she is feeling better. Physicians, who play an important role in helping their patients adhere to treatment, may neglect to ask patients how often they are taking their medications, or may be unwilling to accommodate a patient’s request to change dosages or try a new treatment. Some patients report that side effects of the medications seem worse than the illness itself. Further, substance abuse can interfere with the effectiveness of treatment, leading patients to discontinue medications. When a complicated treatment plan is added to any of these factors, good adherence may become even more challenging.

Fortunately, there are many strategies that patients, doctors, and families can use to improve adherence and prevent worsening of the illness. Some antipsychotic medications, including haloperidol (Haldol®), fluphenazine (Prolixin®), perphenazine (Trilafon®) and others, are available in long-acting injectable forms that eliminate the need to take pills every day. A major goal of current research on treatments for schizophrenia is to develop a wider variety of long-acting antipsychotics, especially the newer agents with milder side effects, which can be delivered through injection. Medication calendars or pill boxes labeled with the days of the week can help patients and caregivers know when medications have or have not been taken. Using electronic timers that beep when medications should be taken, or pairing medication taking with routine daily events like meals, can help patients remember and adhere to their dosing schedule. Engaging family members in observing oral medication taking by patients can help ensure adherence. In addition, through a variety of other methods of adherence monitoring, doctors can identify when pill taking is a problem for their patients and can work with them to make adherence easier. It is important to help motivate patients to continue taking their medications properly.

In addition to any of these adherence strategies, patient and family education about schizophrenia, its symptoms, and the medications being prescribed to treat the disease is an important part of the treatment process and helps support the rationale for good adherence. (Source: excerpt from Schizophrenia: NIMH)

Schizophrenia: NIMH (Excerpt)

Antipsychotic drugs have proven to be crucial in relieving the psychotic symptoms of schizophrenia – hallucinations, delusions, and incoherence – but are not consistent in relieving the behavioral symptoms of the disorder. Even when patients with schizophrenia are relatively free of psychotic symptoms, many still have extraordinary difficulty with communication, motivation, self-care, and establishing and maintaining relationships with others. Moreover, because patients with schizophrenia frequently become ill during the critical career-forming years of life (e.g., ages 18 to 35), they are less likely to complete the training required for skilled work. As a result, many with schizophrenia not only suffer thinking and emotional difficulties, but lack social and work skills and experience as well.

It is with these psychological, social, and occupational problems that psychosocial treatments may help most. While psychosocial approaches have limited value for acutely psychotic patients (those who are out of touch with reality or have prominent hallucinations or delusions), they may be useful for patients with less severe symptoms or for patients whose psychotic symptoms are under control. Numerous forms of psychosocial therapy are available for people with schizophrenia, and most focus on improving the patient’s social functioning – whether in the hospital or community, at home, or on the job. Some of these approaches are described here. Unfortunately, the availability of different forms of treatment varies greatly from place to place.

  • Rehabilitation

Broadly defined, rehabilitation includes a wide array of non-medical interventions for those with schizophrenia. Rehabilitation programs emphasize social and vocational training to help patients and former patients overcome difficulties in these areas. Programs may include vocational counseling, job training, problem-solving and money management skills, use of public transportation, and social skills training. These approaches are important for the success of the community-centered treatment of schizophrenia, because they provide discharged patients with the skills necessary to lead productive lives outside the sheltered confines of a mental hospital.

  • Individual Psychotherapy

Individual psychotherapy involves regularly scheduled talks between the patient and a mental health professional such as a psychiatrist, psychologist, psychiatric social worker, or nurse. The sessions may focus on current or past problems, experiences, thoughts, feelings, or relationships. By sharing experiences with a trained empathic person – talking about their world with someone outside it – individuals with schizophrenia may gradually come to understand more about themselves and their problems. They can also learn to sort out the real from the unreal and distorted. Recent studies indicate that supportive, reality-oriented, individual psychotherapy, and cognitive-behavioral approaches that teach coping and problem-solving skills, can be beneficial for outpatients with schizophrenia. However, psychotherapy is not a substitute for antipsychotic medication, and it is most helpful once drug treatment first has relieved a patient’s psychotic symptoms.

  • Family Education

Very often, patients with schizophrenia are discharged from the hospital into the care of their family; so it is important that family members learn all they can about schizophrenia and understand the difficulties and problems associated with the illness. It is also helpful for family members to learn ways to minimize the patient’s chance of relapse – for example, by using different treatment adherence strategies – and to be aware of the various kinds of outpatient and family services available in the period after hospitalization. Family “psychoeducation,” which includes teaching various coping strategies and problem-solving skills, may help families deal more effectively with their ill relative and may contribute to an improved outcome for the patient.

  • Self-Help Groups

Self-help groups for people and families dealing with schizophrenia are becoming increasingly common. Although not led by a professional therapist, these groups may be therapeutic because members provide continuing mutual support as well as comfort in knowing that they are not alone in the problems they face. Self-help groups may also serve other important functions. Families working together can more effectively serve as advocates for needed research and hospital and community treatment programs. Patients acting as a group rather than individually may be better able to dispel stigma and draw public attention to such abuses as discrimination against the mentally ill.

Family and peer support and advocacy groups are very active and provide useful information and assistance for patients and families of patients with schizophrenia and other mental disorders. (Source: excerpt from Schizophrenia: NIMH)

When Someone Has Schizophrenia: NIMH (Excerpt)

The newer medications for schizophrenia—the atypical antipsychotics—are very effective in the treatment of psychosis, including hallucinations and delusions, and may also help treat the symptoms of reduced motivation or blunted emotional expression.16 Intensive case management, cognitive-behavioral approaches that teach coping and problem-solving skills, family educational interventions, and vocational rehabilitation can provide additional benefit.2 Evidence suggests that early and sustained treatment involving antipsychotic medication improves the long-term course of schizophrenia.17 Over time, many people with schizophrenia learn successful ways of managing even severe symptoms.

Because schizophrenia sometimes impairs thinking and problem solving, some people may not recognize they are ill and may refuse treatment. Others may stop treatment because of medication side effects, because they feel their medication is no longer working, or because of forgetfulness or disorganized thinking. People with schizophrenia who stop taking prescribed medication are at high risk for a relapse of illness.18 A good doctor-patient relationship may help people with schizophrenia continue to take medications as prescribed. (Source: excerpt from When Someone Has Schizophrenia: NIMH)

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