Schizophrenia (Treatment)
In this post I will be discussing the treatment method for schizophrenia. If this is your first time coming across my blog, stop right here and please check out the post I did on the diagnostic criteria for schizophrenia. However if you already know all of that information and wanted some insight into how treatment looks for this specific disorder, please continue on.
Like most of the disorders, sources state that a combination of medication and therapy is the best way to treat schizophrenia. Due to the nature of this specific disorder, I’m inclined to agree. There is a level of psychosis that is involved with this disorder and I don’t feel like therapy alone is the best way to approach this.
So let’s start with possible medications first…
Medications
Now my education is limited when it comes to medications, specifically antipsychotics. Even though I work in this field, I never had the pleasure of taking a psychopharmacology class that was in depth enough for me to know which medications help with specific disorders. I know names but that is as far as my knowledge goes. However, one of the goals for the year is to find an acceptable psychopharmacology class or training that I can use to inform my future practice.
For the sake of schizophrenia there are three types of medications that would be used depending on the client. There are various reasons why certain medications work for certain people but wouldn’t work on others. They could be reluctant to taking medication which makes prescribing medication difficult. They may need a higher/lower dose than others with similar diagnostic criteria. The side effects could be so severe that medication seems like a long shot. Whatever the reason, prescribing medication is not an exact science. Even though we would think that it is, we won’t know how the body reacts to the medication until it is taken and then trial and error will ensue. But the three types of medication are first-generation antipsychotics, second-generation antipsychotics, and long-acting injectable antipsychotics.
First-generation antipsychotics
- Chlorpromazine
- Fluphenazine
- Haloperidol
- Perphenazine
According to the mayoclinic, these have higher potential for negative side effects than the second-generation antipsychotics however they are cheaper which would impact the decision in prescribing it.
Second-generation antipsychotics
- Aripiprazole (Abilify)
- Asenapine (Saphris)
- Brexpiprazole (Rexulti)
- Cariprazine (Vraylar)
- Clozapine (Clozaril, Versacloz)
- Iloperidone (Fanapt)
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Paliperidone (Invega)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
- Ziprasidone (Geodon)
These are the newer antipsychotics that have lower negative side effects however it is a bit more expensive than the first-generation ones.
Long-acting injectable antipsychotics
- Aripiprazole (Abilify Maintena, Aristada)
- Fluphenazine decanoate
- Haloperidol decanoate
- Paliperidone (Invega Sustenna, Invega Trinza)
- Risperidone (Risperdal Consta, Perseris)
These are normally given on a bi-weekly to monthly basis. I’ve seen this very helpful (and it was stated in the same mayoclinc article) in individuals that have issues with medication adherence or prefer to take fewer pills on a regular basis.
Once the psychosis has been treated with the antipsychotic medications then actual therapy can begin. It’s very hard to have a meaningful therapeutic session while someone is actively hallucinating or has a fixed delusion to the point of no return. These need to be addressed first to start seeing any progress with therapeutic sessions. According to WebMD (yes I know, just stay with me) some of the accepted types of therapy are;
- CBT
o I wrote a post about this, please check it out here if you’re interested
- Family therapy
o To help the family as well manage the symptoms and to be a positive influence on the individual with the disorder
- Peer-to-peer counseling
o To provide the individual with a real life example of someone else with the same disorder that has been able to continue living with the disorder with minimal issues.
With a combination of medication and therapy, it shouldn’t be difficult for an individual diagnosed with schizophrenia to go on living their lives within the community. However, like always, the first step needs to be taken in order for any change to happen. I hope that you enjoyed my two-part post on schizophrenia and the treatment. I may continue to do posts on disorders in this fashion. One post solely on the disorder and another on the treatment. This way you’re not overloaded with information. Otherwise, pass this on to someone you feel like may benefit from this information and enjoy your day.