Schizophrenia cannot be cured. That’s because it is unknown what causes it. Antipsychotic medications can help treat many of the symptoms of schizophrenia. In the acute, psychotic phase, medications play an important role in the treatment of schizophrenia. Discussions, social support, support from family and friends and rehabilitation are also very important for successful treatment.
The treatment of schizophrenia
Much research is still being done into the cause of schizophrenia and the effectiveness of treatments. Because the cause is unknown, it is difficult to develop effective therapies. The treatments of the past consisted of; insulin coma, electronconvulsive therapy (ECT), lobotomy . The insulin coma was accidentally invented by Sakel from Vienna. He discovered that administering a large amount of insulin made the psychotic symptoms disappear. This was because the insulin caused a hypoglycemic shock (a blood sugar level that was too low), causing the patient to become dazed.
ECT was developed in the 1940s for the treatment of psychoses. There is no known success in applying this therapy to schizophrenia . There was a lot of resistance to this form of therapy among patients and in society, because it was considered more of a torture method than therapy. The development of ECT has improved in recent decades to such an extent that torture is no longer involved. However, brain damage can occur as a result of ECR. Moreover, the advent of anti-psychotics has made ECT redundant.
Lobotomy
This method involved cutting the connecting nerves between two hemispheres of the brain to treat schizophrenia. This method is no longer used, partly due to the advent of anti-psychotics.
Much research is still being done into the cause of schizophrenia and the effectiveness of treatments. Because the cause is not fully known, it is difficult to develop effective therapies. Because the disease has different symptoms, different treatments are also possible. The symptoms are divided into positive and negative symptoms. The positive symptoms cause an excess or decrease in normal functions. Normal functions include: cognitive thinking. This includes concentration, learning and memory problems.
The positive symptoms are other:
- Hallucinations (changes in perception, such as hearing voices or seeing abnormal things that are not there)
- Delusions (fixed, often bizarre, beliefs that are not based on reality, for example believing that one’s thoughts are controlled by an outside force)
- Paranoid (the belief that others are plotting against you)
- Illogical, incoherent thinking
These symptoms are called psychotic episodes.
The negative symptoms include:
- Loss of energy
- Reduced skills or motivation
- Emotional withdrawal
The treatment of schizophrenia is usually started with medication. The medication used for this includes traditional anti-psychotics, such as Haloperidol. The effect of this medication ensures that the positive symptoms of the disease decrease. However, this medication does not reduce the negative symptoms and has, among other things, movement disorders as a side effect. As a result, atypical antipsychotics are often chosen for medication treatment. These ensure a decrease in both positive and negative symptoms and, to a lesser extent, have the side effect of movement disorders. Types of atypical anti-psychotics include:
- clozapine (Leponex®)
- olanzapine (Zyprexa®)
- risperidone (Risperdal®)
- quetiapine (Seroquel®)
- aripiprazole (Abilify®)
Other medications that are commonly used in people with schizophrenia are tranquilizers to reduce anxiety, such as benzodiazepines.
In addition to drug treatment, other treatments are also used. These treatments are very diverse and include: part-time treatment or admission. A client is eligible for part-time treatment if the diagnosis has not yet been completed or if the diagnosis of schizophrenia has just been made. The client can then stay for observation in a hospital department for a number of half days a week. If a client experiences psychotic episodes several times a week , they may be admitted to prevent harm to themselves. The symptoms can also be reduced and stabilized with medication.
Outpatient treatment
This treatment can take place in, for example, a sheltered housing facility. From here the client can function independently and it can be determined individually what treatment/support is needed. This could, for example, be learning skills, structuring the day and night rhythm and taking medication on time . In this way, the client is not completely dependent on care and their skills are increased.
Social skills training
These trainings are aimed at strengthening the skills that a person with schizophrenia needs to be able to reintegrate and function in work, school and family . A client also learns to take care of himself.
Information, advice and support
Information and advice is mainly given to informal caregivers, who may be family or friends of the client. This information may be about the disease schizophrenia . By providing insight into the disease and tips on how to deal with the disease, an attempt is made to reduce the burden on informal caregivers . This can be done individually but also through group work. The advantage of group work is that informal caregivers can share experiences and support each other through recognition.