Comprehensive treatment for schizophrenia
As with any mental disorder, treating schizophrenia requires an integrated approach. It is impossible to treat a person’s soul in isolation from his body, just as it is impossible to carry out therapy for schizophrenia only by biological methods, even with the most modern drugs, psychotherapeutic help is needed , training of the patient’s relatives and his most necessary skills.
The timing of the initiation of treatment for schizophrenia plays a huge role. If the diagnosis of the disease is made in a timely manner, then with proper therapy, it is possible to prevent the development of irreversible changes in the brain. It is generally accepted that treatment is especially effective if it is carried out within the next two years after the onset of the disease. But even if the disease has existed for a long time, it is possible to significantly help a person suffering from schizophrenia and those close to him. For a psychiatrist, it is important what exactly suffered as a result of the disease. It is important to determine the state of certain structures of the brain, how the endocrine glands, the organs of the cardiovascular and digestive systems of the body function.
Of particular importance is the patient’s personality, his attitude to treatment, the stigma of the diagnosis of “schizophrenia”, to the attending physician. Without complete trust in the doctor, effective treatment for schizophrenia becomes impossible. It is no coincidence that the treatment of this disease requires the work of not only a psychiatrist, psychotherapist, social worker, but also regular classes with a clinical psychologist, who initially conducts pathopsychological, neuropsychological and psychophysiological diagnostic research of memory, attention, thinking, perception, and only then selects for a person suffering from schizophrenia a person the necessary complex of psychological trainings.
Drug therapy for schizophrenia
Modern drug therapy for schizophrenia has long left the antipsychotics and antidepressants so popular in the eighties of the twentieth century in the past .
Today, the use of haloperidol, triftazine, cyclodol, melipramine and even amitriptyline for the treatment of schizophrenia rather indicates the low qualifications of the attending physician and the presence of a large number of complications from various organs of the patient, especially if the latter takes several drugs for a long time. Atypical antipsychotics, especially those that have recently appeared: rispiridone, quentiapine, olanzepine, amisulpiride, have significant advantages over other drugs that were previously used in the treatment of schizophrenia. The absence of side effects with the correct choice of the drug and its adequate dosage for the patient, the effect not only on delusions and hallucinations, but also on isolation, passivity, lack of initiative, poor thinking, negative attitude towards loved ones, memory, attention and thinking of the patient – all this makes atypical antipsychotics are irreplaceable means of biological therapy for schizophrenia. The experience of treating this disease shows the importance of using modern drugs for this purpose, which have a metabolic effect in relation to brain tissues: mildranate, mexidol, berlition, cerebrolysin, milgam.
Modern biological therapy of schizophrenia is necessarily carried out under the control of the patient’s hormonal status, assessment of his neurophysiological and psychophysiological parameters. There are treatment – resistant forms of schizophrenia. But, firstly, there are not so many of them, and secondly, there are ways to overcome this resistance: laser irradiation of blood, light treatment, and finally, electroconvulsive therapy. Again, here we are talking about the exact clinical diagnosis of the disease, implying the prediction of its course. It is completely unacceptable for a person with schizophrenia to be in a psychiatric hospital for a long time, especially if he is idle there and is left to himself. It is possible to stop an acute condition of a patient with schizophrenia within two to three weeks, and then a full-fledged medical, psychological and social rehabilitation of the patient is necessary . Here it is desirable to use modern methods of rehabilitation, including a variety of methods (psychoanalysis, cognitive and existential therapy, therapy with creative self-expression, etc.) and forms of psychotherapy (individual, group, family).
The Role of Psychiatric Education in the Treatment of Schizophrenia
The important role of the psychiatrist in the education of the patient in the field of psychiatry should be emphasized. The patient should know what symptoms of a mental disorder he has, what should be done to prevent an exacerbation of the disease, what should be the diet and how to behave with relatives. When teaching the patient the basics of psychiatry, the necessary social skills of self-service, it is advisable to conduct group sessions, actively use role-playing games, in particular, modeling relationships with the patient’s family and friends, teaching the patient a conflict-free solution to difficult situations. Effective treatment of schizophrenia requires physiotherapy, hydrotherapy, massage, regular exercise therapy in the pool and gym. The patient’s passivity leads to a chronic course of the disease, contributes to the growth of negative symptoms.
Prevention of relapse of schizophrenia
Of particular importance in the treatment of schizophrenia is therapy aimed at preventing the recurrence of the disease. Recently, drugs with a prolonged effect have been actively used for this purpose: rispolept – consta, fluanksol – depot, and less often due to a slight effect on the negative symptoms of clopixol – depot. Moditen is practically not used – depot, which has a large number of side effects and complications. As a rule, supportive treatment of schizophrenia should be long-term and include a long period of observation of the patient’s condition, taking into account the dynamics of hormonal, neurophysiological and biochemical parameters, systematic psychotherapy with the patient. It is required to teach the patient’s relatives, the correct tactics of behavior, preventing the occurrence of a relapse of schizophrenia.