The anti–psychotics possibly act on the dopamine levels in the brain and thus help in reducing the hallucinations and delusions and curbing disorganized bizarre behavior. Like all medications, however, anti–psyhotic drugs should be taken only under the careful monitoring of a psychiatrist. Maintenance medication is vital for preventing a relapse. Approximately 40 – 50 per cent of those who stop the medication immediately on discharge from the hospital have a relapse within 1 year. However, if the patients continued taking medication beyond the first year, relapse rates fell to 10 per cent, Maintenance therapy can be given for a long time, even up to 2–3 years, without any major problems, provided it is under the guidance of a psychiatrist.
The second phase of treatment which is equally important is “Aftercare”, which involves helping the partially recovered patient continue recovery while residing in the community. Aftercare programs help the patient to deal with the anxiety.
Depression and confusion that linger after the major symptoms have abated psychotherapy at this stage offers understanding, reassurance, careful insights, and suggestions for developing self–esteem and handling the emotional aspects of the disorder. Often, psychiatrists have to work closely with family members to help them understand the illness and provide an environment which is free from criticism, hostility, and emotional over involvement. A change in the patient’s living and working environment may be suggested to reduce stressful situations.
In aftercare, anti–psychotic maintenance medication serves as a protective cover and buffers the patient from life stresses. Generally, psychiatrists choose a combination of medication, ECT’s and psychotherapy, and modulate them to suit the patient’s individual needs, so that finally the patient may work, live at home, and enjoy the activities that he did previous to developing the schizophrenia.
Points to be kept in mind during rehabilitation
Stages of rehabilitation
During the entire rehabilitation program the relatives have to be taken into full confidence and given appropriate family counseling as to how to deal with the patient, preventing them from expressing their criticisms and negative comments, as well as helping them cope with the erratic behavior patterns, social withdrawal, emotional blunting or apathy demonstrated from time to time by the previously psychotic patient.
Wherever possible, the psychiatrist with or without the assistance of social workers or the family doctor, has to take a personal interest in the social contracts of the patient, paying regular visits to the work environment and keeping in touch with the patients’ friend–circle thereby positively reinforcing the social circuit and network.
The face to face meetings of the patient, his relatives and friends with other patients who are a few steps ahead in the rehabilitation program (often in group therapy) or with other patients who have been completely rehabilitated helps in increasing the confidence of the patient. These meetings also increase the overall co–operation and the accessibility of the patient as well as his relatives to the rehabilitation program.
The answer, in the ultimate analysis, to the final question often asked by patients, their relatives and referring doctors alike, as to whether schizophrenia is treatable or not, is a positive and emphatic “Yes”. With modern day anti–psychotics and the best of psychotherapeutic care and rehabilitation available, schizophrenia is no longer the dreaded disease that it once was.A schizophrenic patient is ultimately able to function on a normal level in terms of business, job, education, family, social and spiritual life, and does not in any way feel different or inferior to his non–schizophrenic counterparts.
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I have schizophrenia and have tried multiple drugs and am mostly allergic to anti psychotics so my response be prerogative. I currently take 1200 lithium, flexiril for neuralgia pain tardive dyskenisia and grimace facial muscle pain, metoprolol tartrate for hypertension due to inflammation or other, and ambien for sleep terror disorder. I have constant auditory and visual hallucinations with two other personalities that try to takeover my main personality for use of my day to day body and I have found that Ambien and other hypnotic sedatives work better than lithium and all other drugs I have taken, I take ten mg ambien and if I stay awake it causes the voices to fall asleep and become much less responsive and much less hallucinatory, though it increases the persistent sexual arousal syndrome they cause as they move around but even this is less in all at its peak. If they could develop a sedative hypnotic i could take during the daytime that does not cause visual hallucinations I would take it and it would be seventy five percent effective rather than the dull twenty five percent effectiveness of lithium and other antipsychotics that do not cause (in some cases) even worse symptoms than the schizophrenia bacteria by itself without any chemical compounds at all.
