Antipsychotic or neuroleptic medications work by changing the balances of chemicals in the brain and are used to control the symptoms of the illness. These medications are effective but are also associated with uncomfortable and sometimes dangerous side effects and unfortunately, as a result, many people do not take the medications they need. Common side effects from traditional antipsychotics (the ones that mostly control the positive symptoms of schizophrenia: hallucinations, delusions, confusion)include sedation, weight gain, and "extrapyramidal symptoms" such as muscle contractions, problems of movement and gait, and feelings of inner restlessness or "jitters". Long-term risks include a movement disorder called "tardive dyskinesia," which involves involuntary movements of the facial muscles or tongue. Newer agents known as "atypical" antipsychotics appear to have a somewhat safer and more tolerable side-effect profile and appear to effectively treat the positive as well as the negative symptoms of schizophrenia (such as depression and emotional withdrawal).  They also appear to help people who have not benefited from the older traditional medications.  Drug treatment is usually continuous, as relapse of symptoms is common when medication is discontinued.

Supportive and problem-focused forms of psychotherapy may be helpful for many individuals. Behavioral techniques such as "social skills training" can be used in a therapeutic setting, or in the client's natural environment, to promote social and occupational functioning. Family interventions that combine support and education about schizophrenia ("psychoeducation") appear to help families cope and reduce relapse. Clients who lack family and social support may be helped by intensive case management programs that emphasize active outreach and linkage to a range of community support services.

Prognosis

There are many different potential outcomes of schizophrenia. Most people with schizophrenia find that their symptoms improve with medication, and some achieve substantial control of the symptoms over time. However, many others experience functional disability and are at risk for repeated acute episodes, particularly during the early stages of the illness. Supported housing, vocational rehabilitation, and other community support programs may be essential to their community tenure. People with the most severe forms of this disorder may remain too disabled to live independently, requiring group homes or other long-term, structured living environments.

Complications

• Noncompliance with medication will frequently lead to a relapse of symptoms.
• Physical illness occurs at high rates among people with schizophrenia due to psychiatric treatment itself (such as side effects from medication) and living conditions associated with chronic disability. These may go undetected because of poor access to medical care and because of difficulties communicating with health-care providers.
• Persons with schizophrenia have a high risk of developing a coexisting substance abuse problem, and use of alcohol and/or drugs increases the risk of relapse.

Call Your Health Care Provider If:

• voices are telling you to hurt yourself.
• you are unable to care for yourself.
• you are feeling hopeless and overwhelmed.
• you feel like you cannot leave the house.
• you are seeing things that aren't really there.

Ency. home > Disease > S > Schizophrenia

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