Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
What are treatments for schizophrenia and the side effects of those treatments?
Medications
While there are a number of helpful treatments available, medication remains
the cornerstone of treatment for people with schizophrenia. These medications are often referred to as antipsychotics since
they help decrease the intensity of psychotic symptoms. Many health-care
professionals prescribe one of these medications, sometimes in combination of
one or more other psychiatric medications, in order to maximize the benefit for
the person with schizophrenia.
Medications that are thought to be particularly effective in treating
positive symptoms of schizophrenia include olanzapine
(Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (Geodon),
aripiprazole (Abilify), paliperidone (Invega), asenapine (Saphis), lurasidone (Latuda), and lloperidone (Fanapt). These
medications are the newer group of antipsychotic medications, also called second-generation antipsychotics. They are known for having the ability to work quickly
compared to many other psychiatric medications. As a group of medications, side
effects that occur most often include sleepiness, dizziness, and increased
appetite. Weight gain, which may be associated with higher blood sugar levels,
elevated blood lipid levels, and sometimes increased levels of a hormone called
prolactin, may also occur. Although older antipsychotic
medications in this class like haloperidol (Haldol), perphenazine (Trilafon), and molindone (Moban) are more
likely to cause muscle stiffness, shakiness, and very rarely uncoordinated muscle
twitches (tardive dyskinesia) that can be permanent, health-care practitioners
appropriately monitor the people they treat for these potential side effects as
well. Also, more recent research regarding all antipsychotic medication seems to
demonstrate that the older (first-generation) antipsychotics are just as
effective as the newer ones and have no higher rate of people stopping treatment
because of any side effect the medications cause. Not all medications that treat schizophrenia in adults have been approved
for use in treating childhood schizophrenia.
Mood-stabilizer medications like lithium (Lithobid), divalproex (Depakote),
carbamazepine (Tegretol), and lamotrigine (Lamictal) can be useful in treating mood swings
that sometimes occur individuals who have a diagnosable mood disorder in
addition to psychotic symptoms (for example, schizoaffective disorder, depression in
addition to schizophrenia). These medications may take a bit longer to work
compared to the antipsychotic medications. Some (for example, lithium, divalproex, and
carbamazepine) require monitoring of medication blood levels, and some can be
associated with birth defects when taken by pregnant women.
Antidepressant medications are the primary medical treatment for the
depression that can often accompany schizophrenia. Examples of antidepressants
that are commonly prescribed for that purpose include serotonergic (SSRI)
medications that affect serotonin levels like fluoxetine (Prozac), sertraline
(Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro);
combination serotonergic/adrenergic medications (SNRIs) like venlafaxine
(Effexor) and duloxetine (Cymbalta), as well as bupropion (Wellbutrin), which
is a dopaminergic (affecting dopamine levels) antidepressant medication.
Despite its stigmatized history, electroconvulsive therapy (ECT) can be a
viable treatment for people whose schizophrenia has inadequately responded to a
number of medication trials and psychosocial interventions.
When treating pregnant individuals with schizophrenia, health-care
practitioners take great care to balance the need to maintain the person's more
stable thoughts and behavior while minimizing the risks that medications used to
treat this disorder may present. While some medications that treat schizophrenia
may carry risks to the fetus in pregnancy and during breastfeeding, careful
monitoring of how much medication is administered and the health of the fetus
and of the mother can go a long way toward protecting the fetus from any such risks,
while maximizing the chance that the fetus will grow in the healthier
environment afforded by an emotionally healthy mother.
Psychosocial interventions
Family psycho-education: In addition to educating family members about the
symptoms, course, and treatment of schizophrenia, this form of treatment consists
of providing family support, problem-solving skills, and access to care providers
during times of crises. When this intervention is consistently provided for at
least several months, it has been found to decrease the relapse rate for the
individual with schizophrenia and improve the person's social and emotional
outcomes. Also, the burden that family members experience as a result of having
a loved one with schizophrenia is lessened, family members tend to be more
knowledgeable about the disorder and feel more supported by the professionals
involved, and family relationships are improved.
Assertive community treatment (ACT): This intervention consists of members of
the person's treatment team meeting with that individual on a daily basis, in
community settings (for example, home, work, or other places the person with
schizophrenia frequents) rather than in an office or hospital setting. The
treatment team is made up of a variety of professionals. For example, a
psychiatrist, nurse, case manager, employment counselor, and substance-abuse
counselor often make up an ACT team. ACT tends to be successful in
reducing how often people with schizophrenia are hospitalized or become
homeless.
Substance abuse treatment: Providing medical and psychosocial interventions that address substance abuse should be an integral part of treatment as about 50% of individuals with schizophrenia
suffer from some kind of substance abuse or dependence.
Social skills training: Also called illness management and recovery
programming, social-skills training involves teaching clients ways to handle
social situations appropriately. It often involves the person scripting
(thinking through or role-playing) situations that occur in social settings in
order to prepare for those situations when they actually occur. This treatment
type has been found to help people with schizophrenia resist using drugs of
abuse, as well as improve their relationships with health-care professionals and
with people at work.
Supported employment: This intervention provides supports like a work coach
(someone who periodically or consistently counsels the client in the workplace),
as well as instruction on constructing a résumé, interviewing for jobs, and
education and support for employers to hire individuals with chronic mental
illness. Supported employment has been found to help
schizophrenia sufferers secure employment, earn more money, and increase the
number of hours they are able to work.
Cognitive behavioral therapy (CBT): CBT is a reality-based intervention that
focuses on helping a client understand and change patterns that tend to
interfere with his or her ability to interact with others and otherwise
function. Except for people who are actively psychotic, CBT has been found to
help individuals with schizophrenia decrease symptoms and improve their ability
to function socially. This intervention can be done either individually or in
group sessions.
Weight management: Educating people with schizophrenia about weight gain and
related health problems that can be a side effect of some antipsychotic and
other psychiatric medications has been found to be helpful in resulting in a
modest weight loss. That is also true when schizophrenia sufferers are provided
with behavioral interventions to assist with weight loss.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Dissociative identity disorder (formerly known as multiple personality disorder or split personality disorder) is a mental illness in which a person has at least two distinct personalities. Symptoms and signs include lapses in memory, feeling unreal, blackouts in time, hearing voices in their head that are not their own, not recognizing themselves in the mirror, and finding items in one's possession but not recalling how they were acquired. Treatment usually involves psychotherapy, medications, and sometimes hypnosis.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
Antisocial personality disorder (ASPD) has many symptoms, signs, and causes. Therapy is one treatment option for antisocial personality disorder. It is closely related to other personality disorders (PD), such as borderline personality disorder and narcissistic personality disorder.
Psychotic disorders are a group of serious illnesses that affect the mind. Different types of psychotic disorders include schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, shared psychotic disorder, delusional disorder, substance-induced psychotic disorder, paraphrenia, and psychotic disorders due to medical conditions.
Schizoaffective disorder is a mental illness that features schizophrenia and a mood disorder, either major depression or bipolar disorder. Symptoms include agitation, suicidal thoughts, little need for sleep, delusions, hallucinations, and poor motivation. Treatment may involve psychotherapy, medication, skills training, or hospitalization.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
Compulsive gambling is a disorder that affects millions in the U.S. Symptoms and signs include a preoccupation with gambling, lying to family or loved ones to hide gambling, committing crimes to finance gambling, and risking importance relationships and employment due to gambling. Treatment may incorporate participation in Gamblers' Anonymous, psychotherapy, and medications like carbamazepine, topiramate, lithium, naltrexone, antidepressants, clomipramine, and fluvoxamine.
About 5 million children and adolescents in the U.S. suffer from a serious mental illness such as eating disorders, anxiety disorders, disruptive behavior disorders, pervasive development disorders, elimination disorders, learning disorders, schizophrenia, tic disorders, and mood disorders. Symptoms of mental illness include frequent outbursts of anger, hyperactivity, fear of gaining weight, excessive worrying, frequent temper tantrums, and hearing voices that aren't there. Treatment may involve medication, psychotherapy, and creative therapies.
Brief psychotic disorder is a short-term mental illness that features psychotic symptoms. There are three forms of brief psychotic disorder. The first occurs shortly after a major stress, the second has no apparent trauma that triggers the illness, and the third is associated with postpartum onset. Symptoms include hallucinations, delusions, unusual behavior, disorientation, changes in eating and sleeping, and speech that doesn't make sense. Treatment typically involves medication and psychotherapy.
Factitious disorders are conditions in which people pretend to have physical or mental illnesses when they aren't sick. These people may lie about or fake symptoms to obtain the sympathy and attention given to people who are genuinely ill. Symptoms of factitious disorders include dramatic, inconsistent medical history, the presence of many surgical scars, and a history of seeking treatment at many different hospitals.
Mental Health RSS
Healthy Living Tips
This site complies with the