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During an acute episode of schizophrenia,
hospitalization is often required to prevent self-inflicted harm or
harm to others, and to provide for the person's basic needs such as
food, rest, and hygiene.
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. 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. They also 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. |