Schizophrenia is usually treated with medicine along with talking therapy or art sessions. Though the treatment is lifelong. The Community Health Teams are used for treatment. They provide day-to-day support, care, and medication to the patient but also ensures that the patient has independence.
Care Program Approach
Schizophrenia most often starts in adolescence, between the ages of 15 and 25. In 35% to 40% of cases, it manifests itself as acute onset, with delirious flushes. Hospitalization is often necessary during the first episode. Once the mental disorder has been diagnosed, the care is comprehensive: it can involve several professionals (general practitioner, psychiatrist, etc.) often coordinated by a referent caregiver. A therapeutic strategy is carried out for each patient according to their biological and social clinical context.
Medicines alone are not enough and must be accompanied by psychological support. Supportive and accompanying psychotherapy (individual or group) is essential for the patient with schizophrenia and is the initial step. Based on a relationship of trust and continuity
Between the patient and the caregiver (s), it aims to:
- Restore contact with reality;
- Restore mental functioning abilities;
- Promote thought process and verbal expression of emotions.
These sessions can be conducted in either of the following ways:
Individual psychotherapy: Here therapist teaches the patients how to deal with thoughts and behaviors. Learns to tell difference between what is real and what’s not.
- Cognitive behavior therapy: Changing thinking and behavior. Teaching them how to deal with hallucinations.
- Cognitive Enhancement Therapy: It helps the person to improve their memory, reasoning, paying attention, and organizing their thoughts.
The patient after the psychotherapy sessions needs to be taught how to be a part of society. Hence, methods are used to get the patient to interact with society. A few of them are as below:
Family education: The family of the patient is given knowledge about psychosis and schizophrenia which might be helpful for someone known to them.
Social skills training: The person is trained how to indulge in society, improving communication skills and interactions in society.
Social Recovery Therapy: The person is taught to focus on setting goals and achieving goals. Which rejuvenates one with a sense of positivity, optimism, and self-confidence.
Rehabilitation: Helps a person suffering from schizophrenia prepare for a job, or to keep a job, or to find a suitable job.
Art Therapy: Helping the person to express their thoughts not only through words but also through art. It may even help one choose it as their career later.
Based on neuroleptics, drugs that act on brain receptors, they can greatly reduce the symptoms of schizophrenia (they do not “cure” the disease), and allow a return to an almost normal life. They cause side effects but less. There are different drugs:
First-generation Antipsychotics: these drugs are used as standard pharmacological treatment but they have drastic side effects. It should be used only when the previous course of treatment has failed. These drugs possess the ability to develop a movement disorder that may or may not be reversible.
- Thiothixene (Navane)
- Pimozide (Orap)
- Chlorpromazine (Thorazine)
- Perphenazine (Trilafon)
- Fluphenazine (Prolixin)
- Haloperidol (Haldol)
- Trifluoperazine (Stelazine)
- Loxapine (Loxitane)
- Thioridazine (Mellaril)
Second-generation Antipsychotics: these drugs are recommended as first for treatment, especially in adolescents, as more a favorable neurological efficacy-tolerance profile. These drugs are believed to reduce the side effects and risks caused by them (such as stiff muscles or tremors, etc)
- Aripiprazole (Abilify)
- Iloperidone (Fanapt)
- Olanzapine (Zyprexa)
- Lurasidone (Latuda)
- Paliperidone (Invega)
- Brexpiprazole (Rexulti)
- Asenapine (Saphris)
- Cariprazine (Vraylar)
- Quetiapine (Seroquel)
- Clozapine (Clozaril, Versacloz)
- Ziprasidone (Geodon)
- Risperidone (Risperdal)
Electroconvulsive therapy (ECT)
ECT is given under special psychiatric conditions. In this method, an electrical stimulation i.e. a very small controlled electric current is applied to the cerebral cortex through the brain under general anesthesia. It can be used in case of intolerance to or contraindication to antipsychotics in certain states of acute schizophrenia, or if there is a persistence of severe psychotic symptoms. It usually involves 2-3 treatments per week continued for several weeks. The series of this therapy helps one improve the mood and thinking process.