Schizophrenia Programs provide care at all stages of the illness. Services include prevention, treatment for first episode psychosis, assessment programs, rehabilitation, and care for the severely and persistently mentally ill. Depending on how severe their symptoms are, people with schizophrenia may be treated as outpatients or they may be hospitalized. Today, the illness is treated primarily with a combination of medication and psychosocial interventions.
Medications called neuroleptics or antipsychotic drugs are among the most important medical advances for treating schizophrenia. Because of these drugs, many people with schizophrenia no longer need to be hospitalized for years. Most are able to live in the community, needing hospitalization for the illness only if they relapse. There are many different types of antipsychotic medications as they are the main class of drugs used to treat schizophrenia, but other types of medication may also be prescribed to treat particular symptoms such as depression, anxiety or sleep difficulties. These drugs are not a solution for everyone and can have extreme side effects.
The most common reasons for people to stop taking medication are: they don’t understand its importance; they start to feel better and assume they don’t need it anymore; the medication isn’t working and so there is no benefit to taking it; or they experience unwanted side effects. Side effects cause different levels of discomfort and pain, and vary highly from person to person. The short-term side effects appear relatively soon after starting a medication and typically go away by themselves after a few days. If not, alternative medications can be prescribed.
The persistent side effects, on the other hand, are those that don’t go away when the medicine is stopped. The most common of these is tardive dyskinesia (TD), the symptoms are involuntary jerky muscle movements. TD most often appears in facial movements (e.g., of the mouth, tongue and lips) but can also occur in limbs, or other muscle systems. An acute, life-threatening side effect known as neuroleptic malignant syndrome (NMS) can occur when using an antipsychotic, especially early on in the treatment process, if dosage levels are rapidly increased or if it is used in combination with other drugs. Rigidity, hyperthermia, delirium, and autonomic instability are indicators of NMS. If these symptoms appear, it is necessary to hospitalize the individual in order to establish supportive treatment and a future course of therapy.
Psychosocial interventions are also used to help individuals with schizophrenia. Ideally, a variety of approaches are used, such as case management, counselling, centre or clubhouse-based programs, and housing programs with built-in support or flexible outside support. Case managers are clinicians that link people to agencies and services, communicate with families and other caregivers, and monitor the individual’s satisfaction and progress. Their work may include help with housing, vocational, social, educational and financial needs, or crisis intervention — depending on their clients’ needs at any given time. In addition to coordinating these services, case managers may also act as counsellors and therapists and link with medical services, to address such issues as medication and other medical needs.