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Treatment for Schizophrenia
When your friend or
relative first becomes unwell he or she is usually treated in hospital,
either as an in-patient or outpatient. After that, the person who has
been ill can often be treated while living at home, with the support of
friends and family.
Diagnosis
For a psychiatrist to diagnose schizophrenia,
the person must be showing that his or her thought patterns, perceptions,
emotions and behaviour have changed. He or she might be showing some
of the signs and symptoms mentioned in FACT SHEET 2, such as
hallucinations, delusions or apathy.
It must also be clear that
these symptoms and behaviours have followed a recognisable pattern
over a period of time. For example, the person must have shown,
as a result of his or her illness, a decreased ability to work,
to relate to others or to take care of him or herself. Continuous
signs of the illness must have been present for at least six
months, which is why it is important that carers have the
opportunity to talk to medical and/or nursing staff about the recent history of the
person they care for.
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Medication
This is often the first line of treatment
used in schizophrenia. The most widely used drugs are neuroleptics
(also called antipsychotics). Neuroleptics alleviate the symptoms
of schizophrenia by blocking the path of dopamine, a chemical
messenger in the brain. Dopamine is a chemical that we all have
in some quantity. However, in schizophrenia, it is believed that
an excessive amount is present.
With the right medication, some
improvements may be seen fairly quickly although it can take a
few weeks before all the symptoms respond. As everyone responds
differently to a given drug, it may be a matter of time before
the best medication is found for an individual.
Most people are
recommended to keep taking the prescribed drugs for months if
not years. This is to ensure that the person remains well for
as long as possible.
Depot injections
Some neuroleptics are available as depot injections
which are given into a muscle, usually the hip, and can last in the system for
between one and six weeks.
Side effects Side effects
are common with neuroleptic preparations. They include:
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Sedation, a feeling of drowsiness and/or poor concentration.
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Those affecting the autonomic nervous system, such as lowered blood
pressure when lying down or standing up quickly causing a feeling of
dizziness, constipation, dry mouth, blurred vision and occasionally
urinary hesitancy or retention.
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Those affecting the area of the
brain called the hypothalmus, such as, for women, irregular periods
or failure to ovulate, or for men, growth of breast tissue or
impotence.
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Those affecting the muscles, such as trembling,
muscular rigidity or cramp-like spasms.
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Tardive dyskinesia,
which is the development of uncontrollable movements, initially in
the face but affecting other parts of the body.
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Weight gain.
However, not everyone experiences all the side
effects mentioned above and there are other treatments which can counter some of the unwanted effects. If you or the person you
care about have any concerns about side effects, mention them to the
medical practitioner who prescribes the medication in question. Your
pharmacist can also provide helpful advice on medication.
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Other forms of treatment
Psychological treatment
Once someone has been stabilised on suitable medication,
psychological treatment can sometimes be effective. Psychological treatment
is a broad term used to describe any therapeutic approach which aims to
adapt thought and behaviours and it can be offered in conjunction with
medication.
Each Health Board area has different resources available
and may offer different forms of psychological treatments. These
include:
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Counselling
Where the individual can explore personal
issues in a confidential and safe environment.
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Group therapy
Where those recovering from acute symptoms can explore some of their
issues with others. This is not ideal for everyone but it can provide
a vital source of support for some people.
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Family therapy
Which explores the whole family
as one unit in a time-limited focused piece of intense work.
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Cognitive therapy
Generally offered by psychologists,
which focuses on helping the person to adapt their behaviour
and cope more readily with the symptoms of their illness.
Rehabilitation
This involves various forms of occupational therapy which
aims to help someone regain everyday skills such as shopping,
money management, cooking and social events. New skills such
as computer skills can also be learned, which may lead to
employment opportunities.
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Self help support groups
Self help support groups
such as those run by the Hearing Voices Network can be a
very useful complement or alternative to other forms of
'talking treatment'. They tend to be run, supported and used
by individuals who are affected by hearing voices of some kind.
There is good evidence that discussion between those who hear
voices can help someone to deal with the problem. Not all
those who attend have a diagnosis of schizophrenia,
although
many people with schizophrenia do attend.
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