Treatment
Works - A Guide to Schizophrenia Treatment
for Consumers and Family
Members
Adapted from the NAMI
Consumer and Family Guide to Schizophrenia Treatment which
is based on the Schizophrenia PORT
Treatment Recommendations (Schizophrenia Bulletin, Vol. 24, No. 1)
While other intervention may also be helpful, extensive research has shown that the treatments and services described below are proven to benefit patients. The first step in identifying the best treatment is an accurate diagnosis. These treatment recommendations presume an accurate diagnosis of schizophrenia
1. The appropriate and careful
use of antipsychotic medication is essential for the
treatment of schizophrenia.
t You and your doctor should have a choice of all the
available antipsychotic medication as a first-line
treatment. The only exception is clozapine.
t Clozapine should be an option if at least two other antipsychotic medications have failed or if they have
produced intolerable side effects.
t Discuss which antipsychotic
medication will likely be most effective in your situation and will have the
fewest and most tolerable side effects.
t Make sure the lowest possible dose of the drug is
prescribed to reduce the likelihood of side effects.
t Antipsychotic medication should be taken for at least a year or
longer to prevent symptoms from re-occurring or getting worse.
t Going on and off antipsychotic
medication can result in relapse and is not recommended.
t Discuss the use of long-lasting injections of antipsychotic medication if taking a pill every day
presents difficulties or if there is a problem with medication compliance.
t Rapid injection of large doses of antipsychotic
medication should never be given.
t Except when taking clozapine,
blood tests are recommended only if there is a concern about a lack of response
to medication, worry about too much antipsychotic
medication, or a question of treatment compliance.
2. Other medical interventions
can also help.
t Discuss the use of antiparkinson
medications to control side effects of antipsychotic
medications resulting in uncontrollable muscle movements.
t Antidepressant medications, together with antipsychotic medications, can be helpful with symptoms of
depression.
t Benzodiazepines, carbamazepine, or lithium,
together with antipsychotic medications, should be
discussed if serious disruptive, assaultive,
irritability, or excitability persist.
t Electroconvulsive therapy - ECT - may help in the short term, if - and
only if - there is an extremely severe episode of schizophrenia symptoms that
is not responding to medication. ECT is
not a long-term treatment.
3. The right kind of psychotherapy, together with medication, can help to better understand and manage schizophrenia and can help reduce symptoms.
t Psychotherapy aimed at providing information about the
illness, managing symptoms and treatment, providing support, and helping with
problem-solving skills should be provided to all individuals with
schizophrenia.
t Psychotherapy aimed at understanding unconscious
drives or getting at the psychological roots of schizophrenia is never appropriate.
t Family members in regular contact with a patient as
well as others who help the patient day-to-day should receive education about
schizophrenia, support, crisis intervention, and problem-solving skills.
t Family therapy based on the premise that family
dysfunction caused schizophrenia should never
occur.
4. Vocational rehabilitation is essential for the best possible
recovery.
t Supported employment services can help most
individuals with schizophrenia return to work, at least on a part-time basis,
and thus should always be made available.
t Other type of vocational training and supports may
also help.
5. Assertive Community Treatment (ACT) is essential for individuals who suffer repeated relapse and hospitalization and have trouble complying with treatment.
t ACT is a form of treatment provided by a team of
care-providers including doctors, nurses, social workers, and other, who reach
out to individuals with schizophrenia where they live, on a 24-hour-per-day
basis, to monitor symptoms and treatment and to provide treatment and support.
t ACT reduces relapse and hospitalization and improves
treatment compliance and quality of life.
t ACT should be provided to individuals with the most
severe forms of schizophrenia.
NAMI of Greater (312) 563-0445