Medication
The mainstay of psychiatric treatment for schizophrenia is antipsychotic medication. These can reduce the "positive" symptoms of psychosis. Most antipsychotics are thought to take around 7–14 days to have their main effect.
Treatment of schizophrenia changed dramatically in the mid 1950s with the development and introduction of the first antipsychotic chlorpromazine. Others such as haloperidol and trifluoperazine soon followed.
It remains unclear whether the newer antipsychotics reduce the chances of developing neuroleptic malignant syndrome, a rare but serious and potentially fatal neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs.
The two classes of antipsychotics are generally thought equally effective for the treatment of the positive symptoms. Some researchers have suggested that the atypicals offer additional benefit for the negative symptoms and cognitive deficits associated with schizophrenia, although the clinical significance of these effects has yet to be established. Recent reviews have refuted the claim that atypical antipsychotics have fewer extrapyramidal side effects than typical antipsychotics, especially when the latter are used in low doses or when low potency antipsychotics are chosen.
Response of symptoms to medication is variable; "Treatment-resistant schizophrenia" is the failure to respond to 2 or more anti-psychotic medications given in therapeutic doses for 6 weeks or more.Patients in this category may be prescribed clozapine, a medication of superior effectiveness but several potentially lethal side effects including agranulocytosis and myocarditis. Clozapine is the only medication proven to be more effective for persons who do not respond to other types of antipsychotics. It also appears to reduce suicide in people with schizophrenia. As clozapine suppresses the development of bone marrow, in turn reducing white blood cells which can lead to infection, blood tests are taken for the first six months on this medication.
For other patients who are unwilling or unable to take medication regularly, long-acting depot preparations of antipsychotics may be given every two weeks to achieve control. America and Australia are two countries with laws allowing the forced administration of this type of medication on those who refuse but are otherwise stable and living in the community.
Some findings indicate that, in the long term, many schizophrenic individuals function better without antipsychotic medicine. In a 2007 study, only 28% of patients who were not being treated medicinally showed signs of psychotic activity, while 64% of those on antipsychotics had psychotic activity. The authors of the study cautioned that some of this gap may be accounted for by the increased likelihood of symptomatic patients to be placed on antipsychotic medicine, but also noted that some of the difference held even when on-antipsychotic and off-medicine patients of similar prognosis were compared.
Persons diagnosed as having schizophrenia are advised to avoid dietary supplementation of arginine above 30 milligrams per day.
Read more about this topic: Management Of Schizophrenia