Treatments for schizophrenia treatments for

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Treatments for Schizophrenia Treatments for Schizophrenia Medication (Primary) – most affective trtmt is medicat Acute – sedation and “chemical restraint” – slows them down, make you still and unable to move, not in pain just immobolized Chronic – normalization of cognition and behavior. Goal is to normalize behavior, to get the person back to as close as normal functioning as possible 6. BUT overall, compliance < 70% Problem – all the meds suck! Compliance is about 30%. part of the problem is that they cannot get their thinking straight, can't rely on them to take there meds, tough order to comply with. It is helpful to have a social support system where someone is giving them meds. Butt shot is an uneven dose, not all modes are available by depoinjection. Individual Psychotherapy (Adjunctive) – valuable role as an adjunct to meds. Absolutely necessary, helps ppl adjust to illness and helps patient to adjust to the idea of schizophrenia. Have to adjust schema's of self. Adjustment to illness Family Friends Work Love Deal with secondary depression, anxiety Symptom self-monitoring Building compliance with medication Medication for Schizophrenia Medication for Schizophrenia (Antipsychotics, Major Tranquilizers, Neuroleptics) (Antipsychotics, Major Tranquilizers, Neuroleptics) Some Classical Antipsychotics Some Classical Antipsychotics (Rarely Used Currently; Treat Mainly + Symptoms) (Rarely Used Currently; Treat Mainly + Symptoms) Thorazine, Haldol, Prolixin, Stelazine Some Atypical (2 Some Atypical (2 nd Generation) Antipsychotics Generation) Antipsychotics (Treat Both + and – Symptoms) (Treat Both + and – Symptoms) Abilify, Zyprexa, Clozaril, Invega, Risperdal, Seroquel, Geodon
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Note: Abilify and Geodon are weight-neutral the rest makes you gain weight. However antipsychotic function from Abilify is not as strong. The best antipsychotic agent is Clozaril, treats negative-symptoms better than any of the other anti-psychotic. But in 5 of the ppl, they develop a blood disorder and you can die. Side Effects of Antipsychotic Medications Side Effects of Antipsychotic Medications Drowsiness / sedation (can be useful in agitated patients) “Metabolic syndrome” Weight gain (especially in abdomen) Elevated blood lipids (cholesterol & triglycerides) Diabetes (blood glucose dysregulation) Motor side effects (much greater w/classical antipsychotics like Thorazine and Haldol): Akathisia (“cruel restlessness”), e.g., rocking, “Thorazine shuffle” Acute dystonias (lock-jaw, oculogyric crisis(locke of eyes)) – locking of muscles. A shot of benadryl loosens up the muscle, knocks out the symptom Pseudoparkinsonism – producing what looks like parkinsons disease, mostly the first gen meds. Resting Tremor Slowness of movements Muscular rigidity Tardive dyskinesia (rare with 2 nd -generation medications) – if you take the antipsychotic long enough. Sticks with you forever Early “rabbit sign” Eventually, tongue and limb writhing Phases of “Clinical Trials” in Medication Development
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