Treatment of Schizophrenia - Pharmacotherapy, Electroconvulsive Therapy, Psychotherapy and Rehabilitation

Treatment of Schizophrenia

Treatment should be as fast as possible, because the psychotic state in a long time lead to a greater likelihood of patients leading to mental deterioration. Even though the patient may not recover completely, but with treatment and good guidance, the patient can be helped to be able to function continuously, simple work at home or outside, and can raise and educate their children (Maramis, 2009). The type of treatment in patients with schizophrenia (Maramis, 2009), are as follows:

1. Pharmacotherapy

An indication of antipsychotics in schizophrenia is to control the active symptoms and prevent relapse.

Treatment strategy depends on the phase of the disease is acute or chronic. The acute phase is usually characterized by psychotic symptoms (experienced new or recurrent) that need to be addressed immediately. The aim here is to reduce the treatment of severe psychotic symptoms. With phenothiazines, delusions and hallucinations usually disappear within 2-3 weeks. Even still there are delusions and hallucinations, patients are less affected again and become more cooperative, willing to participate in environmental activities and would also work therapy.

After 4-8 weeks, the patient entered the stage of stabilization when the symptoms had resolved to some extent, but the risk of relapse is still high, especially when treatment is interrupted or patients experiencing stress. After the symptoms subside, then the dose was maintained for several more months, if the attack is new the first time. If an attack of schizophrenia was already more than once, then after symptoms subside, the drug was given continuously for one or two years.

After 6 months, patients maintenance phase that aims to prevent recurrence. Patients with chronic schizophrenia, neuroleptic given within a period of unspecified length of time with doses up and down according to the patient's condition. Always have to be wary of the side effects of drugs.

Maintenance strategy is to find the lowest effective dose that can provide protection against recurrence and does not interfere with the patient's psychosocial functioning. Results of treatment would be better if antipsychotic start given in the first two years of the disease. There is no standard dose for this drug, but the dose set individually.

More drug selection based on the profile of side effects and the patient's response to previous treatment. There are some special conditions that need to be considered, such as pregnant women preferred haloperidol, because these drugs have data with the best security. In patients who are sensitive to extrapyramidal side effects better given the atypical antipsychotic, as well as in patients presenting with symptoms of cognitive or prominent negative symptoms.

For the first time patient experienced episodes of schizophrenia, drug treatment should be sought in order not to give any side effects, because a bad experience with the treatment will reduce ketaatanberobatan (compliance) or ketidaksetiaberobatan (adherence). It is recommended to use atypical antipsychotics or typical antipsychotics, but with a low dose.


2. Electroconvulsive Therapy

Electroconvulsive therapy, good results on the kind of catatonic, especially stupor, against schizophrenia simplex effect is disappointing, if only mild symptoms then given electroconvulsive therapy, sometimes the symptoms become more severe.


3. Psychotherapy and rehabilitation

Psychotherapy in the form of psychoanalysis did not bring the expected results, some have argued should not be performed in patients with schizophrenia because it can add insulation and autism. Supportive Psychotherapy individual or group can help patients as well as practical guidance for the purpose of restoring the patient to the community. Cognitive behavioral therapy techniques to try to psien schizophrenia with promising results.

Therapy is an excellent work to encourage people to hang out again with another person, other patients, nurses and doctors. It means that patients do not isolate themselves anymore, because if the patient withdrew and formed bad habits.


From : various source