According to modern experts, treatment of schizophrenia should be comprehensive and individualized. Complex therapy includes psychopharmacotherapy, physical well-being support, and psychosocial intervention. Today, pharmacotherapy is discussed in more detail in scientific circles. Modern medicine uses atypical antipsychotics (second generation antipsychotics) in therapy, which are subjectively better tolerated and are available in various galenic forms. The doctor chooses the optimal treatment based on information about the patient. The clinical picture, dynamics of the disease, individual susceptibility to side effects, previous experience with the use of drugs, and the opinions of close family members or guardians of the patient are taken into account.
Facts about the disease
Schizophrenia is treatable - today there is no cure for the disorder, but the disease can be successfully treated and controlled. The key to success is having strong support and proper therapy.
The victim can have a full life - the use of modern methods of treating schizophrenia can provide patients with satisfactory relationships, the opportunity to perform other activities, work, be a full-fledged part of society, and enjoy life.
A schizophrenic does not need hospitalization - if the disorder is treated correctly, the risk of a crisis condition requiring hospital stay is significantly reduced.
Course of drugs
Modern treatment of schizophrenia, of course, is not limited to hypnosis. Most often, the disease is treated through special medications that can relieve stress and restore clarity of mind and thinking. A psychotherapist must select a course of medications; under no circumstances should you prescribe medications for yourself, and you cannot buy them without a prescription at a pharmacy. After a clinical examination and an accurate diagnosis, the psychotherapist can select the most effective treatment, which will include both medications and psychological help.
Treatment recommendations
Early diagnosis and appropriate treatment for schizophrenia can slow or stop the onset of complications and speed up recovery. If you suspect a disease in a loved one or friend, consult a doctor immediately. Proper therapy can reduce the symptoms of the disorder and allow the person to live independently.
According to Roayl College of Psychiatrists (Britain):
- in 1 out of 5 patients, the condition improves after the 1st episode of schizophrenia up to 5 years;
- 3 out of 5 patients have the same symptoms, which sometimes worsen;
- 1 out of 5 patients have stable unpleasant symptoms.
Step #1 – Participation in the therapeutic process
Early diagnosis of the disorder equals a high chance of improvement. Experienced mental health professionals will conduct the necessary research, prescribe appropriate medications for the treatment of schizophrenia, and monitor the therapeutic course.
Successful therapy depends on a combination of factors. The use of medication alone is not enough. It is necessary that the schizophrenic himself is aware of his illness, communicates with experts, has support, follows the rules of a healthy lifestyle, and follows the therapeutic plan.
Prescribed treatments for schizophrenia must be tailored to the individual needs of the patient. The latter needs to be an active participant in the process, his concerns and needs must be taken into account by doctors. An important condition for effective therapy is the cooperation of the patient himself, his family members and doctors.
Patient's attitude towards treatment
Many fears about schizophrenia are not reality. It is necessary to take the disease seriously, discarding myths - the condition can be improved. It is recommended to communicate with people who see a full-fledged person, despite the diagnosis.
Talk to your doctor to make sure you are taking your medications at the correct dose. Dosage is not only the responsibility of the doctor. Talk to a specialist about the principle of action of drugs for schizophrenia and the side effects after their use.
During therapy, learn to control the symptoms - do not stop using pills. Auxiliary non-drug therapeutic methods will teach you to fight delusional beliefs, ignore obsessions, prevent repeated attacks, and motivate yourself for further treatment.
Define your work and life goals. Schizophrenia is not the inability to work, enter into relationships, or communities. Setting goals and participating in creating a healthy, satisfying life is important.
Step #2 – Create a Support Circle
Support is of great importance in the prospects for drug and non-drug treatment of schizophrenia. The best option is family and friends. The presence of caregivers participating in therapy increases the chances of its impact and effect, preventing relapse.
- Reach out to trusted friends and family members. The immediate environment will help you receive the necessary treatment aimed at controlling symptoms and enjoying a full stay in society. Ask permission to contact them in an emergency. People will be flattered by a request for support.
- Find a way to stay connected with other people. Don't quit your job if you have one. If you don't have a job, consider volunteering. Alternative psychological ways to cope with the disease include participating in a schizophrenic support group, going to church, etc.
- Take advantage of support opportunities available in your area. Ask your doctor about services available in your area, hospitals, mental health clinics.
The role of a favorable environment
Treatment for schizophrenia will not be successful without a stable, supportive place to live. Research shows that schizophrenics recover faster from symptoms of the disorder when they are in their home, surrounded by loved ones. Any environment that provides a feeling of safety can help improve the condition.
Living with your family is a good choice if your loved ones understand and perceive your illness correctly. But your own role is also important. It is necessary not to use drugs, alcohol, follow the therapeutic plan, and use external support services.
Step No. 3 - distribution of medications
When a diagnosis of schizophrenia is made, the patient is prescribed psychopharmaceuticals that have a sedative (calming) effect. But the use of medications for schizophrenia is part of a comprehensive treatment of the disease.
- Drugs do not treat schizophrenia. Medicines reduce the manifestation of psychotic symptoms of the disease (hallucinations, paranoid symptoms, delusions, thought disorders).
- Each group of medications is designed to treat specific symptoms: for example, anxiolytics reduce psychotic symptoms, but do not eliminate accompanying symptoms (social stress, emotional instability, lack of motivation).
- Do not ignore the side effects of therapeutic agents. Drugs used in the treatment of schizophrenia can have very unpleasant effects (different for each patient, but they cannot be ignored, because they are very expressive). The patient's quality of life is very important, so if they appear, talk to your doctor. He will recommend reducing the dose or prescribing another remedy.
- You cannot reduce the dosage on your own! Changing the dose without the supervision of a specialist is dangerous and can lead to repeated attacks and other complications. If you have problems using the drug or feel it is not effective, talk to your doctor.
Determining appropriate medications
Many people with schizophrenics require long-acting medications that control symptoms and have minimal side effects, so choosing the right medications may take longer.
Like all medications, schizophrenia medications may have different effects on each patient. It is impossible to determine in advance how effective antipsychotics will be and what dose will be the most acceptable. Finding the right remedy and determining its dosage is a process of error and trial. It also takes some time for the effects of antipsychotic drugs to take effect.
Reactions to some medications take a few days to appear, while others take weeks to months to see a response. Mostly improvement is noticeable 4-6 weeks after the first use of the medicine. If antipsychotics are not effective during this period, your doctor may recommend increasing the dose or prescribing a different medication.
Step No. 4 – compliance with healthy lifestyle rules
The symptoms and course of schizophrenia vary from person to person - some may have a milder course of the disorder, others may have a more severe course of the disorder. Regardless of the situation, it is important to take care of yourself. The more a person maintains overall health, the less inadequate they feel.
- Stress control. Overexertion and nervousness can cause psychosis and worsen the symptoms of schizophrenia, therefore stress control is very important. This will prevent the development of depressive states (according to experts, the brain compound galanin is responsible for the development of depression). Set boundaries, both at work and at home. Don't try to do more than you can, don't rush unnecessarily.
- Adequate night's rest. A person undergoing treatment will need more sleep than a healthy person, despite their biological clock. Many schizophrenics have problems sleeping; In this case, lifestyle adjustments will help.
- Drugs, alcohol. Medical research suggests a link between drugs and schizophrenia. The use of psychotropic drugs complicates the course and aggravates the signs of schizophrenia. If you have problems with using drugs or alcohol, seek help.
- Physical activity. Research shows that regular exercise is a good recipe for relieving symptoms of the disease. The ideal is 30 minutes of physical activity per day. Do exercises that make you feel good. When you are not working, engage in activities that give you a sense of purpose and success. Find a passion, a hobby. It's good to help other people.
Step #5 – Explore Opportunities in Your Community
Most countries develop various government programs and public services that benefit schizophrenics. Explore your options, contact local mental health agencies, social service agencies, support groups, and municipal authorities.
Labor and social skills
Vocational and social rehabilitation teaches people with schizophrenia basic life skills, existence in families and society. There are a number of rehabilitation programs that teach independent living. Retraining programs will teach you professional skills and help you find a suitable type of employment. Other programs will also help (training in financial management, communication with other people).
Periods of schizophrenic psychosis
Drug treatment for schizophrenia depends on the phase of psychosis.
- Acute phase. Lasts from several hours to several months. Characteristic development of negative symptoms is loss of interest in life, depressed mood, irritability, desire for solitude. Often patients show increased interest in esotericism, religion or philosophy. Mania of persecution may be observed, which manifests itself in the form of a feeling of strong fear for one’s life and unmotivated attacks of aggression. Against this background, delusions of grandeur develop, when the patient considers himself a famous person, appropriates other people's works, films, books, etc. These symptoms are characteristic of the paranoid form of schizophrenia. The attacks are stopped in the hospital by prescribing antipsychotics and tranquilizers.
- State stabilization phase. It begins after the onset of the disease. It can last from several days to several years. This period is characterized as recovery. It is very important in terms of correcting the psycho-emotional background. Tranquilizers and antipsychotics in some cases completely stop the clinical picture. The drugs are taken for life, but are prescribed in smaller doses. With proper treatment, remission can reach up to 10 years.
Drug therapy
Basic therapy for schizophrenia is the use of psychotropic drugs from the group of antipsychotics (neuroleptics). Today there are many drugs that differ in their mechanism of action and are prescribed depending on the stage of the disease. They counteract hallucinations, delusional ideas, calm or, conversely, stimulate motor skills, and eliminate depressive and manic states. Nootropics for schizophrenia stimulate cognitive functions that support memory. Combination therapy is often prescribed - a combination of several drugs.
Some products are available in depot form - they are used once every few weeks.
Basal antipsychotics:
- Levomepromazine;
- Tyrodazine;
- Clopenthixol and Zuclopenthixol;
- Chlorpromazine.
Side effects: excessive sedation to the point of drowsiness, hypotension (with an overdose, fainting and even coma are possible).
Incisive antipsychotics:
- Prochlorperazine;
- Fluphenazine;
- Haloperidol;
- Perphenazine;
- Flupenthixol.
Side effects: extrapyramidal syndromes.
Atypical antipsychotics:
- Clozapine;
- ziprasidone;
- Olanzapine;
- Risperidone;
- Sulpride;
- Triaprid;
- Sertindole;
- Quetiapine.
Side effects: minor.
If schizophrenia does not respond to treatment, clozapine (with monitoring of blood counts due to the risk of adverse effects on hematopoiesis) or electroconvulsive therapy is prescribed.
Since schizophrenia often distorts the functioning of a person (not only adult men and women, but also adolescents, since it often manifests itself at a young age) in basic life patterns, drug therapy is complemented by psychological and social methods. Their goal is to increase a person’s resistance to stress, teach effective forms of communication, and the usual requirements of the social environment.
How do cytokines work in schizophrenia?
Experts are still debating the effectiveness of cytokines in mental disorders
Proponents of cytokine therapy claim that these proteins effectively relieve the productive symptoms of schizophrenia. Experts believe that the mechanism of development of schizophrenia is in many ways similar to autoimmune diseases, however, in this case, the immune system does not attack any organ or part of the epidermis, but some areas of the central nervous system. In this case, the use of cytokines makes it possible to stop this process, achieving remission.
The effectiveness of cytokine therapy is a highly controversial issue. First of all, this is due to the fact that the causes of schizophrenia have not yet been precisely studied, and the autoimmune nature of the disease has not been confirmed. Today, most doctors agree that this disease is a congenital defect in the structure of the central nervous system, which cannot be corrected by any available method.
Despite the fact that cytokines are active against malignant cells, they cannot “patch” the human nervous system, so cytokine therapy for schizophrenia is considered an alternative technique with unproven effectiveness.
At the same time, scientists have established a connection between the neurobiological reactions of the brain and the human immune system. In this case, the effect of cytokines on general immunity can actually have a positive effect on the course of schizophrenia, normalizing the production of dopamine, which is considered one of the “culprits” in the development of this mental illness.
In addition, the use of cytokines can presumably regulate the balance of neurotransmitters and restore connections between brain neurons, which in the future opens up great advantages for the use of these proteins in psychiatry and neurology.
Indications, contraindications and side effects
Main indications for cytokine therapy:
- infectious and viral diseases;
- malignant processes and inoperable cancer;
- autoimmune reactions;
- immunodeficiency;
- leukopenia;
- multiple sclerosis.
As you can see, schizophrenia is not on the list of indications, since the effectiveness of cytokine therapy for this diagnosis remains in question. At the same time, active research is currently underway on the effect of cytokines on the nervous system during the productive symptoms of schizophrenia and the sluggish form of the disease (recurrent schizophrenia). There are no exact statistical data on the effectiveness of the drugs, but these two diagnoses are conditionally included in the list of indications.
Exact contraindications and side effects of cytokine therapy have not been established. It is believed that drugs of this group cannot be used in cases of severe damage to vital organs and in cases of severe infectious-toxic shock. In addition, it is impossible to predict the body's response to the supply of cytokines in febrile schizophrenia.
Psychotherapy
Psychotherapy is effective once antipsychotic treatment eliminates the symptoms of schizophrenia. Psychiatry has a positive effect on people who are treated as outpatients in a psychiatric hospital and their condition is monitored by an expert. Psychotherapy is based on communication between the patient and a psychiatrist or psychologist. The patient has the opportunity to talk about what is happening at the moment, what experiences are present. The expert focuses on current and past issues. During the session, the patient can better understand his problems and the things happening within or around him.
Part of psychotherapy is hypnosis performed by a specialist in this field. It helps to identify hidden thoughts and their origins that are unconscious to the schizophrenic himself.
Therapeutic stages
Treatment for schizophrenia usually occurs in several stages. The course of the disease is individual, differs for each patient, depending on many factors. Depending on the development and course of the disease, various methods of its treatment are used.
Treatment of acute symptoms (attacks)
In the treatment of acute (sudden) stages of the disease, new antipsychotic drugs are most often used today. Medicines containing risperidone or olanzapine are the first choice. Older (classical) types of antipsychotic drugs are recommended for patients who pose a danger to themselves or to others, because they have a more pronounced calming effect. The dose is adjusted individually, depending on the level of the drug in the blood. The earlier the disease is diagnosed, the lower the doses are sufficient to suppress symptoms, and the fewer side effects appear during treatment.
Sometimes antipsychotics are combined with sedatives (in very agitated patients). In such cases, the dose of the antipsychotic drug can be reduced. If one medicine is not effective, the doctor decides to use another.
Treatment of chronic conditions (maintenance therapy)
Maintenance therapy involves the use of a new type of antipsychotic medication. Patients without a guarantee of timely administration of medications need to use a depot form of the medication. For long-term treatment, the doctor chooses a drug that is effective for the 1st episode of schizophrenia.
Treatment of resistant disease
Treatment of an illness that responds poorly to several different antipsychotics involves the use of products containing Clozapine. Patience is needed here; improvement may only occur after a few months. However, if other medicine has not worked, Clozapine capsules can provide significant relief to the patient and those around him.
New way
The clear cause of schizophrenia is still unknown. Causal factors associated with the development of the disease are heredity, psychosocial factors, especially the environment in which the patient grows up. But we are talking about a disease that can be cured!
With early detection and proper treatment, patients can live a normal life. The ideal form of treatment is the injection form (shots), the main advantage of which is a threefold reduction in the risk of a new outbreak.
Latest news in therapy
Recently, a once-monthly, extended-release injectable formulation was introduced. Benefit: Improvement of long-term negative symptoms of schizophrenic illness (improved patient motivation, concentration, easier adherence to daily routine).
In addition, the new generation of drugs has milder side effects, in particular, effects on motor abilities. The possibility of injection only once a month also reduces the risk of stigmatization of the patient and gives a greater chance of returning to normal life.
Today, operations are being carried out using stem cells to treat schizophrenia. This therapy has been proven to provide complete relief from the disease.
What are cytokines?
Cytokines are special proteins that serve for “communication” between body cells
Cytokines are specific peptides or proteins secreted by immune cells. These proteins serve to transmit so-called “information” signals between cells of various tissues and systems of the body. The bulk of cytokines are secreted by lymphocytes - cells of the immune system responsible for providing and supporting humoral immunity.
Cytokines are synthesized by the spleen, leukocytes and lymphocytes, and even connective tissue. Thanks to these formations, signals are transported between cells, which are transmitted sequentially from cell to cell.
The synthesis and distribution of cytokines in the body is a short-term and clearly regulated process. The resulting protein can attack a specific cell, weakening or neutralizing its action, or strengthen cells susceptible to pathological effects.
Cytokines play an important role in ensuring the smooth functioning of the body. However, their concentration is so low that there is a need to use specially synthesized cytokines in the form of drugs in the treatment of various diseases.
Eastern medicine
To alleviate the symptoms of the disease, non-traditional (folk) therapeutic methods are also used, although their effectiveness is questionable.
One way is acupuncture. The description of the procedure is simple - the specialist pricks 2 needles near the ear and 2 near the navel. The ears are a part of the body that is also used in acupressure. It is recommended to massage them to improve mental state.
Part of the treatment is herbal teas to maintain energy circulation and replenish vitamins. Herbs for teas include cardamom, basil, Indian gooseberry, licorice, ginseng, chamomile, ginkgo biloba.
ECT – electroconvulsive therapy or electric shock
Electroconvulsive therapy (ECT) causes anxiety in the majority of the population. Even the name “electric shock” is not conducive. Forget about literary and film works, the reality is not so bright. During ECT, the patient lies on a bed under anesthesia. Electrodes are attached to his head. The doctor turns on a device that generates a weak electric current. The patient tenses a little, trembles, after a few seconds his body calms down. No scary grimaces, screams, pain.
Electroconvulsive therapy was introduced by Drs. Curletti and Bini about 80 years ago. Today the method is used for depression and other disorders that do not respond to medications. ECT helps in about 80% of cases. Usually the procedure is repeated 5-10 times.
ECT is only used for people who have not responded to other therapeutic approaches. Even today, the mechanism of action of the method is unknown; in some people it causes memory problems. Therefore, other treatment regimens are advantageous.
