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Treatment

The treatment of schizophrenia may be divided into two stages
The first stage of treatment program is essentially aimed at reducing the acute psychotic symptoms and helping the patient re–establish contact with reality. This phase usually involves admission of the patient into a hospital and administering a biological line of treatment injectable anti–psychotics and very often ECT’s. Short duration psychoses may respond without ECT’s but advanced severe cases do require ECT’s.

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.

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