Schizophrenia: symptoms and treatment

Schizophrenia (also called psychosis) is a psychic disorder characterized by delusional ideas, behavioral alterations, hallucinations, speech disorders, cognitive symptoms and affective flattening. In psychosis, for example, one may have the belief that he is the victim of an international conspiracy, one can be certain of particular attention from an important person or one may be convinced that he has special powers. A person with schizophrenia may also hear voices, speak in an incomprehensible way, have difficulty in attention and apathy.
At the onset of the disease, more frequently in adolescence, the subjects affected by this disorder may manifest non-specific symptoms: social withdrawal, apathy, daily rituals. Early therapeutic intervention plays an important role in reducing duration, alleviating initial symptoms and delaying the onset of psychotic symptoms. Concerning therapy, pharmacological and psychotherapeutic approaches have been proposed. Antipsychotic drugs and cognitive behavioral therapy are the first choice treatments (Dimitrakopoulos et al., 2015).

Video titled “Schizophrenia simulation”, uploaded on youtube by That Rick 904 on 2017, 24th of july:

The antipsychotics drugs usually prescribed are those of first and second generation. The difference between the two types of drugs lies in terms of efficacy and potential side effects. Second generation drugs, compared to first generation antipsychotics, in fact, would present a reduced risk of motor side effects (tremors, involuntary movements, rigidity), hormonal side effects (prolactin increase) and cardiac side effects (prolongation of the QT interval).
Long-acting injectable antipsychotics are a valid alternative for the treatment of schizophrenia as they allow the schizophrenic patient, who often has no awareness of disease, to maintain therapeutic continuity, increasing the chances of clinical compensation. The second generation long-acting antipsychotics would allow to their long duration of action to be associated with the benefits of second generation antipsychotics (Jarema et al., 2015). Several clinical studies have demonstrated the safety and efficacy of these drugs in acute psychosis (De Berardis et al., 2013).
Four long-acting second generation antipsychotics present on the market are olanzapine, risperidone, aripiprazole and paliperidone (Jarema et al., 2015). Injections are usually performed monthly at hospitals, clinics and mental health centers.

References:

De Berardis D et al. Efficacy and safety of long acting injectable atypical antipsychotics: a review (2013). Curr Clin Pharmacol. 8(3): 256-64.

Dimitrakopoulos S et al. Early psychotic experiences: Interventions, problems and perspectives (2015). Psychiatriki. 26(1): 45-54.

Jarema M et al (2015). Guidelines for the use of second-generation long-acting antipsychotics (2015). Psychiatr Pol. 49(2): 225-41.

Tiziana Corteccioni

About Tiziana Corteccioni

Tiziana Corteccioni

MD, Specialist in Psychiatry, Psychotherapist, Cognitive behavioral therapist.

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