Schizophrenia

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Schizophrenia Treatment

During an acute episode of schizophrenia, hospitalization is often required to prevent self-inflicted harm or harm to others, and to provide for the person's basic needs such as food, rest, and hygiene.

Antipsychotic or neuroleptic medications work by changing the balances of chemicals in the brain and are used to control the symptoms of the illness. These medications are effective but are also associated with uncomfortable and sometimes dangerous side effects. Unfortunately, as a result, many people do not take the medications they need.

Common side effects from traditional antipsychotics (the ones that mostly control the positive symptoms of schizophrenia: hallucinations, delusions, confusion) include sedation, weight gain, and "extrapyramidal symptoms" (such as muscle contractions, problems of movement and gait, and feelings of inner restlessness or "jitters").

Long-term risks include a movement disorder called "tardive dyskinesia," which involves involuntary movements of the facial muscles or tongue. Newer agents known as "atypical" antipsychotics appear to have a somewhat safer and more tolerable side-effect profile. They also appear to effectively treat the positive as well as the negative symptoms of schizophrenia (such as depression and emotional withdrawal).

They also appear to help people who have not benefited from the older traditional medications. Drug treatment is usually continuous, as relapse of symptoms is common when medication is discontinued.

Supportive and problem-focused forms of psychotherapy may be helpful for many individuals. Behavioral techniques, such as "social skills training", can be used in a therapeutic setting, or in the client's natural environment to promote social and occupational functioning.

Family interventions that combine support and education about schizophrenia (psychoeducation) appear to help families cope and reduce relapse. Clients who lack family and social support may be helped by intensive case management programs that emphasize active outreach and linkage to a range of community support services.