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Staying on Track with Schizophrenia

Posted Aug 24 2008 1:49pm
ANNOUNCER: Schizophrenia is a serious metal illness characterized by delusions, hallucinations, disordered thinking and social withdrawal.

JOHN KANE, MD: Schizophrenia is an illness that affects about 1 percent of the population worldwide. It tends to begin in late adolescence or early adulthood, and it really affects the way people think, the way they perceive reality. It also affects behavior, mood, motivation and general cognitive functioning.

ANNOUNCER: Treatment for schizophrenia usually involves medications called anti-psychotics. They help control symptoms of the disease, and may help guard against relapse. Antipsychotics generally fall into two classes: older and newer drugs.

JOHN KANE, MD: The older medications—we refer to them as conventional antipsychotic drugs or first generation drugs—often caused a series of side effects referred to as drug-induced Parkinsonism, a slowing of movements, a rigidity, a loss of facial expression, tremor, restlessness and things like that. The newer drugs are much less likely to cause those side effects.

ANNOUNCER: Drug therapy for schizophrenia must usually be taken for years—often for life. The symptoms of the disease, however, may make that kind of adherence especially difficult.

ROBERT CONLEY, MD: People with schizophrenia have a real problem with adherence to medicine, because they have a hard time with their cognition. They don't really so much have a hard time remembering things as they do learning new things. So a complicated medication regime, one where you have to take a lot of pills or it changes from day to day is something that they'll have a very hard time working with, for example.

Another problem is that people with schizophrenia often aren't very social, and often our social network is what will help us remember to take medicines.

ANNOUNCER: Strategies to encourage adherence to a drug regimen include: simplifying the regimen, the creative use of calendars, maintaining regular routines and what experts call "psycho-education."

JOHN KANE, MD: Patients and their families need to understand the nature of the illness and what the medication is for, what the medication can do, what the medication can't do, what the side effects might be, how it should be taken and so forth. Unless someone really understands the benefits of taking medication, they're going to have a difficult time doing it.

ROBERT CONLEY, MD: A strategy that just about anyone can use is to simplify a medication regime; that's very, very important. And to really work with the treating clinician to do that, to make the fewest number of doses you have to take per day, to try to link them with daily activities that are easily remembered like meals or going to bed, to often use very simple reminder things like pillboxes; they can work very well.

ANNOUNCER: Simplifying drug regimens can also mean using long-acting drugs.

JOHN KANE, MD: There are medications that can be given by injection every two weeks, three weeks, four weeks, depending upon the medicine and depending upon the patient.

ANNOUNCER: It can take a little time to find the medicine that works best. One benefit of using injections is that adherence to therapy is automatically monitored.

JOHN KANE, MD: If someone is on a long acting injectable medication and they miss their injection or their appointment, we know that immediately so that we are instantly aware that this person is now without medication and we can do something to intervene. We can call the family, we can do a home visit, we can do whatever is necessary.

ANNOUNCER: Schizophrenia is a serious illness, but most patients do well with therapy. The key to successful treatment is finding the best medication and staying the course.

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