|
The medications used to treat schizophrenia, commonly referred to as ’antipsychotics’, are generally an effective method for decreasing the psychotic (or ’active’) symptoms of schizophrenia, such as delusions and hallucinations. The newer antipsychotics can also help relieve some of the ’passive’ symptoms (such as confusion, withdrawal, suicidal thoughts and lack of concentration). For many people with schizophrenia, medication will also be needed during stable phases (also called ’maintenance’ or ’recovery’ phases).
While it can sometimes be a temptation to stop taking medication, especially during the recovery phase or when side effects are distressing, it is important to understand the real risks involved in doing so. Studies have concluded that four out of five people who stop taking their medications after a first episode of schizophrenia will relapse.
Any decisions, therefore, to stop, change or alter the dosage of your medication should always involve your doctor. The type and dosage of medication needs to be determined individually for each person and may need to be altered several times until the right combination is achieved. A general rule of thumb is to find the lowest possible dose of medication that effectively reduces the symptoms and prevents relapse. If you or a family member are being treated with medication, make sure you ask:
What are the desired effects of the medication?
Why it is needed?
How and when it is taken?
What side effects can the medication cause?
What special warnings or restrictions apply to the use of the medication?
Remember, although medication is the primary intervention offered, it should not be considered the sole treatment for schizophrenia. Rather, it should be used in combination with other therapies described later in this section.
Types of Medications
Typical antipsychotic medications
Typical antipsychotics (also called ’conventional’ antipsychotics) have been used for the treatment of schizophrenia since the 1950s. They are available in tablet form, long-lasting injections (called ’depot’) and also as fast intramuscular preparations. These older medications are highly effective in the treatment of symptoms in 60-70% of people. However, they are less effective on ’positive’ symptoms and are often associated with unpleasant side effects.
Atypical antipsychotic medications
The emergence of atypical antipsychotic medications has offered great hope for improving the treatment of schizophrenia. Atypical medications appear superior to typical medications in treating the passive symptoms of schizophrenia and they appear to cause fewer extra-pyramidal side effects (involuntary movements such as tremors, muscle spasm or uncontrollable restlessness).
Clozapine (trade name Clozaril)
Clozapine, re-introduced in 1990, was the first atypical antipsychotic and can be helpful for 25%-50% of people who have not responded to other atypical antipsychotics. However, clozapine has a rare but potentially very serious side effect. In less than 1% of those taking clozapine, it can decrease the number of white blood cells necessary to fight infection, a condition that is called ’agranulocytosis’. This means that people receiving clozapine must have their blood checked regularly. It is generally recommended that clozapine be used only after at least two other antipsychotics have not worked.
|
