July 31, 2007

Schizophrenia Treatment Is Evolving

Because schizophrenia is considered the disorder toughest to tackle by the psychiatric community; with symptoms that range from troublesome to severe, venturing away from traditional drug only treatments seems to be goal. An article in the Norwich Bulletin, a Connecticut publication, discusses the care of schizophrenia, and includes input from many professionals.

"It's one of the ones that psychiatry has made big advances in, but we're not that good at yet. We're darn good at depression, and pretty good at bipolar. We're an awful lot better at treating it than we were 50 years ago," said Dr. Brian Benton, medical director of psychiatric services at The William W. Backus Hospital in Norwich.

The article discusses drug treatments for schizophrenia, including the newest releases, Invega, and the “gold-standard” Clozaril.

Even though Invega and Clozaril provide a lot of patients with symptom relief, the psychiatric community still has a lot of work ahead of them. There isn't any medication out there for the treatment of schizophrenia that doesn't cause the risk of tardive dyskinesia -- though newer medications pose less risk, but the risk is still there.

But the article shifts from medications to what is now considered to be an important aspect of treatment, psychosocial interventions, psychoeducation, and family-focused care.

Due to the timing of onset (around 18-24), and the severity of symptoms, it is almost always going to have a large impact on the family system. Because research has found that early treatment seems to have the best results, professionals are encouraging parents to be attuned to “soft symptoms” – which may signify susceptibility to developing schizophrenia – and to look for these symptoms as early as elementary school.

"You want to find it as soon as you can and get them on treatment," Benton said. "The more episodes of severe psychosis, the worse it gets. They think the more severe episodes you have, you don't come back as good. That's true of all mental illnesses."

The article encourages what many professionals now follow, a multimodal approach to treating schizophrenia. This holistic approach would include drug treatments, individual therapy, family-focused therapy, and life skills training.

"A really holistic approach is needed. For some people it's very challenging -- they go through so many trials and errors to find the right treatment, they forget about the fact that recovery requires a broad approach," said Kate Mattias, executive director of the National Alliance on Mental Illness in Connecticut.

The article also emphasizes that schizophrenia, like all other disorders, present on a spectrum. This means that there are degrees of severity, function, and fluctuations in ones recovery. This is important to understand - what’s difficult today, may be better next week. People with schizophrenia are not always severely psychotic, and understanding the disorder can help people cope. Psycho-education models and support groups have attempted to tackle the issue of ignorance or misinformation surrounding schizophrenia.

"Absent education, people may start to feel overwhelmed. We want people to feel optimistic and hopeful about recovery."

"There's an inordinate amount of stigma," Mattias said. "The diagnosis isn't well understood in the population. I think that the common public media images tend to frame the picture of an individual with schizophrenia as scary, violent, very disturbed, with a very refractory illness that can't be treated successfully with medication. That's all myth, and very untrue."

Some very optimistic news from the article is “In fact, Benton estimates 80 to 90 percent of individuals with schizophrenia will function well -- with 80 percent participating in the community independently.”

The article encourages that many individuals go on to live fulfilling lives, in-spite of imperfect treatments..

Schizophrenia treatment a step up the ladder
By Sharma Howard. Norwich Bulletin


Its interesting that its well known today, more the number of psychotic episodes, less good is the prognosis. yet its extremly unfortunate that if the patient is over 21 and is psychotic to the extent that doesn't believe he or she is ill and not violent enough for compulsory hospital admission, whats happening today to them? parents are simply ignored with the excuse that the patient is an adult, so their history can not be taken into account. I know it myself, and am sure many other parents have the same experience that when their adult child is psychotic, behaving strange and their gut feeling telling them that something wrong with their child, yet, a psychiatrist has to follow their ethics ie NOT TO LISTEN TO THE PARENTS/CARER.
Its obvious, treatment is always delayed BY THE PSYCHIATRISTS. parents/carer has to witness many such episodes before any treatment can be initiated sometimes after some disaster. I would like to urge the professionals to give importance to this factor that an adult when become psychotic, for the sake of the patient's own good, please LISTEN to the parents, give importance to their history rather than following a general rule. I
feel if early treatment has good prognosis, then many have been deprived and made disabled simply by delaying treatment BY THE PEOPLE WHO SHOULD HAVE LISTENED AND THEY ARE THE PSYCHIATERISTS.

Posted by: JENA at August 1, 2007 03:04 AM

Mental health "parity" will not improve mental health care. In fact, mental health care will get worse if congess puts more money and power into the hands of the mental health "professionals". Wake up America.

Listen to the giant sucking sound of the freaks who fill the ranks of the psychology and psychiatry profession. Rosalynn Carter, little Wellstone, Patrick Kennedy are unwitting dupes of the pharmaceutical industry and counseling lobbies.

If Paul Wellstone were alive, he'd tell Rosalynn and Patrick to go EFF themselves because they are such blundering destructive jackasses.

Posted by: Sam Mela at August 1, 2007 03:38 PM

"Venturing away from traditional drug treatments seems to be the goal." I have the feeling that the only reason I don't hate p-docs is because I never had to rely on them even when I was hospitalized. I saw one to qualify for benefits and have just cut him loose. Don't hate them and am not anti-meds I just have no use/reason for them so I can afford to say that...for now. The only hope for people with active scz is for advances in picturing the brain. They are really encouraging. See MIT's Technology Review. Once they are able to see the smallest chemical processes they will
be able to at least know what is wrong. Actually,
I think physical (below the neck) counterparts to scz will offer a back door to treatment.

Posted by: longnow at August 1, 2007 09:06 PM

I think if exercise were incorporated into the treatment patients receive in hospitals, the dosage rate for each individual patient would be lower. The disease appears to begin during the reproductive years, and to 'take your mind off of' being an 18-year-old, the solution for young people is usually exercise. I have done a lot of physical labor, and even though I am from a family of geniuses, I think physical work is a great solution for a guy like me. The side effects are bad enough, so if you make exercise part of the treatment, then you can make up for some of the humiliating side effects. I, for one, was very athletic as a kid, and when I finally made good money as an adult, I enlisted the services of a personal trainer to improve my functioning, both on and off duty I might add. 'Exercise is the best medicine' is what my World War II marine corps veteran and psychiatrist told me many times. I made myself a prescription for a personal trainer and eventually I didn't need someone to tell me to exercise. Maybe I could have survived on 2.5 mg of Zyprexa, instead of the 5 mg I took for eight years or the 0 mg I was prescribed when I had my relapse. I do not know. All I know is I am grateful to that former marine for being such an excellent shrink.

Posted by: hmmned at August 10, 2007 10:46 AM

HELP! I've just obtained custody of my 8 year old niece, and we're having some issues that I think are serious...mood swings, temper tantrums, total disregard for authority or rules of any kind, etc. I don't know if there is something serious going on with her, or if she is just being an 8 year old. Any comments or suggestions would be greatly appreciated.

Posted by: new2mommydom at October 17, 2007 03:11 PM

Hi i'm a man with schizophrenia. I have had this mental illness for about 8 yrs and i've learned alot through that period of time. Just hang on no matter what hang on, "the grass is always greener on the other side."
God Bless.

Posted by: Joseph Dilliplane at March 11, 2008 06:13 AM

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