Schizophrenia Treatment

Currently there is no cure for schizophrenia. Because of the severity of the symptoms experienced by a person with schizophrenia, it is often very challenging for the individual to function well in society or to do well at a job.

However, with the proper treatment and medication, some schizophrenic individuals are able to have very productive and enjoyable lives. That being said, many individuals with schizophrenia are in and out of treatment facilities throughout their lives.

Types of Treatment for Schizophrenia

The treatment for schizophrenia generally includes a combination of medication, inpatient treatment, residential or day treatment, therapy, and vocational training.

Medication
For optimal functioning, the majority of individuals with schizophrenia require ongoing medication. Neuroleptics (or antipsychotics) are the primary type of medication used for the treatment of schizophrenia. Neuroleptics help to both reduce or alleviate current symptoms and thwart the recurrence of symptoms. Other medications may also be prescribed, depending on the current symptoms. While in most cases the benefits outweigh the risks, neuroleptics do have many potential side effects. It is important to discuss those with your healthcare provider.
Inpatient Treatment
Usually when a person is first diagnosed with schizophrenia, it is during a time when they have symptoms which significantly impair them. They may even be so disorganized and/or psychotic that they are a potential danger to themselves or others. It is not uncommon for the initial treatment to include both inpatient treatment and medication.
Inpatient treatment usually lasts for several days, but may last for a few weeks. Inpatient psychiatric facilities are typically locked facilities with staff on site 24 hours a day. Depending on the severity of the symptoms, a patient may be on 24-hour observation by the hospital staff. Neuroleptic medication is almost always prescribed at the beginning of hospitalization to help the patient stabilize as quickly as possible.
Residential or Day Treatment
When the schizophrenic patient’s symptoms subside, he may be transferred to a residential or day treatment program for further, but less intense, treatment. Residential programs are similar to inpatient treatment in many ways, although often less restrictive and intensive. Day treatment programs are outpatient programs in which the patient attends for a few hours each day but returns home at the end of the day.
Therapy
Therapy for the schizophrenic patient may be individual, or may include a spouse or family members. Therapy will often take place in all the above settings (inpatient, residential, and day treatment), and may continue on a regular basis--often once a week--when the patient is stabilized. Therapy will often include educating the patient and his spouse or family about his disorder and how to best manage it and cope with it.
Vocational Training
Vocational training is often necessary because of the severity of the disorder. A person with schizophrenia may need help with training for an appropriate type of work suited to accommodate the unique challenges of this disorder.

Treatment Challenges

One of the biggest challenges for schizophrenics is adhering to their treatment regimen. This may be due to a variety of factors, such as homelessness, lack of a good support system, or because they don’t like the side effects of the medication they are taking. Unfortunately, if they stop taking their medication their symptoms usually return in time and they end up hospitalized again, starting the treatment process all over.

Another challenge for schizophrenics, in terms of treatment, occurs when they are experiencing paranoia or “command” hallucinations. Unfortunately, these symptoms may occur even when on medication, for various reasons. Paranoia will often result in resistance to treatment. Patients experiencing command hallucinations (a voice or voices telling them what to do or not do) may stop taking medication if the voice is telling them they should not take it. This creates a vicious cycle, because medication is usually necessary to alleviate or reduce the hallucinations or paranoia which are causing the resistance.

written by Dr. Cheryl Lane, Psy.D.

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