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Wildcard: Treatment Options for Schizophrenia 

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Wildcard: Treatment Options for Schizophrenia 

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This video shows the treatment options and how to remove stigmas on schizophrenia patients.

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In a poll conducted on Instagram by myself, I found that out of 190 people, 55 of them knew somebody who had diagnosed schizophrenia. In the 22 who responded to the question, "Do they take medication, do therapy, or both?", the answers varied. These side effects showed common similarities from the subject expertise articles.
One anonymous answer noted, "Side effects like exhaustion, weight gain, and moodiness were caused due to medication. It has just increased by problems severely"

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Societal Position: "Psychotherapy of Schizophrenia" by Tracy D. Eells

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Societal Position: "Psychotherapy of Schizophrenia" by Tracy D. Eells

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Explored the testing of different groups with medication, therapy and the combination of the two through the last couple decades.
This helps with the exploration of the combination of therapy and medication for schizophrenia patients.
"In general, the best results occurred with the combination of focused psychotherapy, medication management, and a stable living environment for patients".

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ABSTRACTS
Fenton WS: Evolving perspectives on individual psychotherapy for schizophrenia. Schizophrenia Bulletin 2000; 26(1):47-72
Summary: This article provides a history of theory about individual psychotherapy for schizophrenia as well as a literature review of randomized clinical trials that have evaluated individual psychotherapy of schizophrenia. The authors note that the most common treatment for patients with schizophrenia is a combination of prescription antipsychotic medications and some form of individual psychotherapy. In their view, psychotherapy of schizophrenia has been guided historically more by ideology and deference to authoritative opinion than by a foundation of empirical evidence.

The authors identify two theoretical traditions in the history of psychotherapy for schizophrenia. The "investigative" trend grew from the psychoanalytic and Sullivanian traditions and emphasizes the alleviation of emotional difficulties and the elimination of symptoms. The therapy focuses on a thorough examination of the patient's life history and current relationships and on the doctor-patient relationship. Patients with schizophrenia are seen as struggling with basic mistrust and the expectation that others will harm them. Their relationships are marked by ambivalence involving both a longing for merger and withdrawal based on a terror of closeness. Weak or absent ego boundaries result in a failure to differentiate one's own thoughts and impulses from those of others. Therapeutic efforts called for intense focus on establishing a relationship with the patient. Key therapist attributes were seen as basic respect for the patient and an interest in and capacity to tolerate intense affect, dependency, and ambiguous communication.

The "supportive" tradition of psychotherapy for schizophrenia is grounded in the medical model and has been the preference of biologically and pharmacologically oriented clinicians. The treatment emphases are pragmatic and symptom-focused rather than aimed at personality change. Favored therapist interventions include defining reality, offering direct reassurance, giving advice, urging modification of expectations, and actively organizing the environment when necessary.

The research literature review covers three epochs. The first, 1960 to 1975, focused on a medication-versus- psychotherapy paradigm. In six randomized clinical trials reviewed, the authors concluded as follows: 1) no study supported the efficacy of individual psychotherapy as a sole treatment for schizophrenia, and medication-treated groups always demonstrated superior outcome on average whether or not psychotherapy was offered; 2) studies of psychoanalytic psychotherapy that included a follow-up evaluation found no clear advantage for therapy plus drugs versus drugs alone, although one study suggested a better outcome among patients of two highly experienced therapists; and 3) among the forms of psychotherapy evaluated, the most promising was a practical, problem-solving approach emphasizing resolution of current life situational problems.

Research during the second epoch, the 1980s and early 1990s, compared different forms of psychotherapy when combined with medication. This body ofresearch showed that intensive investigative psychotherapy combined with medications appeared tooffer no advantage over less intensive and less costly therapy approaches. Further conclusions were that the distinction between supportive and insight-oriented therapy appeared less meaningful when treating patients with schizophrenia. However, a positive therapeutic alliance was associated with better medication compliance and better outcome. The generally disappointing results from randomized clinical trials and follow-up studies contributed to a decline in the influence of a psychodynamic and intensive individual psychotherapy approach for schizophrenia, and to the increased ascendancy of the biological paradigm.

The third epoch, beginning in the early 1990s and continuing to the present, emphasizes cognitive-behavioral interventions, briefer treatments, and improved adaptation to schizophrenia. Informed by reappraisals of past therapeutic approaches, Hogarty and colleagues developed Personal Therapy (PT) for recently discharged patients with chronic or subchronic schizophrenia. PT is informed by neuropsychological aspects of schizophrenia and includes three phases, each with associated goals and techniques. The overall aims are to enhance personal and social adjustment and to forestall relapse. The results of two three-year randomized clinical trials, found good compliance for PT versus supportive therapy and family psychoeducational treatments. Fifty-four percent of patients advanced to the third phase of PT; the greatest success regarding relapse occurred for PT patients with stable living arrangements.

(The cognitive-behavioral treatments that constitute the second major strand of research in the third epoch are the focus of the present article.)

Comment: This is an excellent, objective review.
Tarrier N, Yusupoff L, Kinney C, McCarthy E, Gledhill A, Haddock G, Morris J: Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia. British Medical Journal 1998; 317:303-307
Summary: Eighty-seven patients with chronic schizophrenia who experienced persistent hallucinations or delusions were assigned to one of three treatment groups by use of a randomized procedure that included stratification according to severity of symptoms and gender. The treatments were intensive cognitive-behavioral therapy (CBT) and routine care, supportive counseling and routine care, and routine care alone. The CBT focused on teaching patients methods of coping with their symptoms, providing training in problem solving, and teaching strategies to reduce risk of relapse. Routine care consisted of medication management and monitoring outpatient follow-up. Twenty sessions were provided during a period of 10 weeks. Results at 3 months after treatment showed significant improvements in the CBT group, but not in the other two groups. The CBT group showed reductions in symptom severity and number of positive symptoms. In addition, significantly more patients treated with CBT showed an improvement of 50% or more in their symptoms.

Comment: This is one of the better-designed studies testing efficacy of CBT in patients with schizophrenia. The sample size is relatively large, and a control group was included. The treatment was relatively intense, was highly structured, and was delivered in an individual format. The findings are particularly noteworthy in that they occurred in addition to routine care.
Kuipers E, Fowler D, Garety P, Chisholm D, Freeman D, Dunn G, Bebbington P, Hadley C: London- East Anglia randomized controlled trial of cognitive-behavioural therapy for psychosis. British Journal of Psychiatry 1998; 173:61-68
Summary: Forty-seven patients who suffered symptoms of psychosis and underwent either cognitive-behavioral therapy and routine medication care or routine care alone were followed up l8 months after baseline. Using the Brief Psychiatric Rating Scale (BPRS) as the primary outcome measure, analyses showed that the CBT group maintained treatment gains that had been achieved by the end of treatment. The routine care group showed no improvement. As compared with the routine care group, the CBT group showed a statistically significant reduction in distress from delusions and a reduction in preoccupation with delusions. Using a 5- point change in BPRS scores as a measure of reliable clinical change, the authors found that 65% of the CBT group showed reliable clinical improvement as compared with 17% of the routine care group at follow-up. These authors also conducted an economic evaluation of their treatment and found that the costs of CBT appeared to have been offset by reduction in service utilization and associated costs during the 9-month follow-up period.

Comment: This study complements that by Tarrier et al. in finding that changes achieved using CBT may be maintained 9 months after the conclusion of treatment. Note that the treatment provided by Kuipers and colleagues occurred over a 9-month time span as compared with the 10-week treatment provided in the study by Tarrier et al. The economic analysis, although based on a small sample, suggests that cognitive-behavioral therapy may lead to reduced healthcare system costs in the longer run despite higher costs at the outset of treatment.
Jakes S, Rhodes J, Turner T: Effectiveness of cognitive therapy for delusions in routine clinical practice. British Journal of Psychiatry 1999; 175:331-335
Summary: The purpose of this study was to assess the effectiveness of cognitive therapy on patients with delusions who were seen in routine clinical work as opposed to patients seen as part of a randomized clinical trial. Eighteen patients with chronic delusions were treated with cognitive therapy that aimed at reducing the intensity of delusional beliefs. The treatment used cognitive challenging, reality testing, and normalization techniques. The authors used a single-case multiple- baseline experimental design that included a control treatment focusing on a problem unrelated to a patient's delusional beliefs. Of the 18 patients, 6 showed reduced conviction in their delusions during cognitive therapy, but not during the control treatment; 7 patients did not change; and 5 showed a variable response. No patients showed a complete absence of conviction in their delusions.

Comment: Although lacking the methodological rigor of other studies I am reviewing, this one has an advantage in that it replicates those findings in a more typical clinical setting. That is, it suggests that treatment effects found in relatively highly controlled clinical trials research hold up in a typical clinical setting.
Pinto A, Pia SL, Mennella R, Giorgio D, DeSimone L: Cognitive-behavioral therapy and clozapine for clients with treatment-refractory schizophrenia. Psychiatric Services 1999; 50(7):901-904
Summary: This study randomly assigned 41 treatment-resistant patients with schizophrenia who had recently started clozapine to either a cognitive-behavioral therapy (CBT) plus social-skills training group or individual supportive psychotherapy. Treatment lasted 6 months. CBT plus social skills training includedmodeling, rehearsal, positive reinforcement, in vivoexercises, and homework assignments. Specific interventions focused on improving patients' ability to manage psychotic symptoms, disputation of irrational beliefs when possible, and enhancing a patient's ability to identify and monitor stress levels. Both groups showed statistically significant change at the end of treatment as measured by the Brief Psychiatric Rating Scale, a scale measuring positive symptoms, and a third scale measuring negative symptoms. The CBT plus social skills training group showed greater improvement, however.

Comment: Despite methodological problems, this study provides further evidence that cognitive-behavioral therapy plus social skills training provided on an individualized basis may be beneficial to patients with schizophrenia in reducing both positive and negative symptoms. It is encouraging to see these findings emerge from a different practice setting in a different country than those reported in previous studies.
Wykes T, Parr A, Landau S: Group treatment of auditory hallucinations: exploratory study of effectiveness. British Journal of Psychiatry 1999; 175:180-185
Summary: Group cognitive-behavioral treatment for psychotic symptoms was explored. Twenty-one patients diagnosed with schizophrenia who had experienced treatment-resistant hallucinations for an average of 14 years underwent 6 treatment sessions emphasizing individual power and control, psychoeducation, and coping strategies. Treatment followed a 6-week waiting time control condition. Results indicated reduced distress from auditory hallucinations and reduced disruption caused by the voices. In addition, there were increases in insight and improvement in coping strategies. These effects were maintained 3 months after treatment concluded. No changes were observed in measures of depression or anxiety.

Comment: Although this study lacks a control group and the effects were relatively small, it suggests that group treatment for schizophrenic patients that specifically targets insight into the illness, auditory hallucinations, and self-esteem may be helpful. The authors emphasized that their results are comparable to those obtained in individual treatment, but are more cost-effective.
Sensky T, Turkington D, Kingdon D, Scott JL, Scott J, Siddle R, O'Carroll M, Barnes TRE: A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication. Archives of General Psychiatry 2000; 57(2):165-172
Summary: The efficacy of manualized cognitive-behavioral therapy developed specifically for schizophrenia was compared with a nonspecific befriending control intervention. Ninety patients received an average of 19 individual treatment sessions over 9 months in addition to their pharmacological treatment. CBT treatment focused on developing a collaborative understanding of the development of symptoms, critically analyzing beliefs about the origin and nature of auditory hallucinations, use of voice diaries, reattribution of the cause of the voices, Socratic questioning to address delusions, and other aspects of thought disorder. Both treatments led to significant reductions in positive and negative symptoms of schizophrenia as well as in symptoms of depression. At a 9-month follow-up evaluation, patients who had received cognitive therapy showed continued improvement, but those in the befriending group did not.

Comment: This is one of the best-designed studies reviewed and shows results comparable to the others. A key aspect of the study is that the patients were selected because their symptoms persisted despite treatment adherence.

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Fenton WS: Evolving perspectives on individual psychotherapy for schizophrenia. Schizophrenia Bulletin 2000; 26(1):47-72 Summary: This article provides a history of theory about individual psychotherapy for schizophrenia as well as a literature review of randomized clinical trials that have evaluated individual psychotherapy of schizophrenia.

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Societal Position: The NY Times : "Drug maker played down risks of schizophrenia medication - Business - International Herald Tribune"

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Societal Position: The NY Times : "Drug maker played down risks of schizophrenia medication - Business - International Herald Tribune"

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In the last 15 years, drug administration has not been completely honest with the side effects of anti psychotics. Zyprexa, one the top prescribed medications for schizophrenia, had strong side effects that caused extreme weight gain and high blood pressure that can result in diabetes.
The authors write, "Lilly's own marketing research found that psychiatrists were consistently saying that many more of their patients developed high blood sugar or diabetes while taking Zyprexa than other anti-psychotic drugs".

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NEW YORK - The drug maker Eli Lilly has engaged in a decade-long effort to downplay the health risks of Zyprexa, its best-selling medication for schizophrenia, according to hundreds of internal Lilly documents and e-mail messages among top company managers.

The documents, given to The New York Times by a lawyer representing mentally ill patients, show that Lilly executives kept important information from doctors about Zyprexa's links to obesity and its tendency to raise blood sugar - both known risk factors for diabetes.

Lilly's own published data, which it told its sales representatives to play down in conversations with doctors, has shown that 30 percent of patients taking Zyprexa gain 22 pounds, 48 kilograms, or more after a year on the drug, and some patients have reported gaining 100 pounds or more. But Lilly was concerned that Zyprexa's sales would be hurt if the company was more forthright about the fact that the drug might cause unmanageable weight gain or diabetes, according to the documents, which cover the period 1995 to 2004.

Zyprexa has become by far Lilly's best-selling product, with sales of $4.2 billion last year, when about two million people worldwide took the drug.

Critics, including the American Diabetes Association, have argued that Zyprexa, introduced in 1996, is more likely to cause diabetes than other widely used schizophrenia drugs. Lilly has consistently denied such a link, and did so again on Friday in a written response to questions about the documents. The company defended Zyprexa's safety, and said the documents had been taken out of context.

But as early as 1999, the documents show that Lilly worried that side effects from Zyprexa, whose chemical name is olanzapine, would hurt sales.

"Olanzapine-associated weight gain and possible hyperglycemia is a major threat to the long-term success of this critically important molecule," Dr. Alan Breier wrote in a November 1999 e-mail message to two-dozen Lilly employees that announced the formation of an "executive steering committee for olanzapine-associated weight changes and hyperglycemia." Hyperglycemia is high blood sugar.

At the time Breier, who is now Lilly's chief medical officer, was the chief scientist on the Zyprexa program.

In 2000, a group of diabetes doctors that Lilly had retained to consider potential links between Zyprexa and diabetes warned the company that "unless we come clean on this, it could get much more serious than we might anticipate," according to an e-mail message from one Lilly manager to another.

And in that year and 2001, the documents show, Lilly's own marketing research found that psychiatrists were consistently saying that many more of their patients developed high blood sugar or diabetes while taking Zyprexa than other anti-psychotic drugs.

The documents were collected for lawsuits on behalf of mentally ill patients against the company. Last year, Lilly agreed to pay $750 million to settle suits by 8,000 people who claimed they developed diabetes or other medical problems after taking Zyprexa. Thousands more suits against the company are pending.

On Friday, in its written response, Lilly said that it believed that Zyprexa remained an important treatment for patients with schizophrenia and bipolar disorder. The company said it had given the Food and Drug Administration all its data from clinical trials and reports of adverse events, as it is legally required to do. Lilly also said it shared data from literature reviews and large studies of Zyprexa's real-world use.

"In summary, there is no scientific evidence establishing that Zyprexa causes diabetes," the company said.

Lilly also said the documents should not have been made public because they might "cause unwarranted fear among patients that will cause them to stop taking their medication."

As did similar documents disclosed by the drug maker Merck last year in response to lawsuits over its painkiller Vioxx, the Lilly documents offer an inside look at how a company marketed a drug while seeking to play down its side effects. Lilly, based in Indianapolis, is the sixth-largest American drug maker, with $14 billion in revenue last year.

The documents - which include e- mail, marketing material, sales projections and scientific reports - are replete with references to Zyprexa's importance to Lilly's future and the need to keep concerns about diabetes and obesity from hurting sales. But that effort became increasingly difficult as doctors saw Zyprexa's side effects, the documents show.

In 2002, for example, Lilly rejected plans to give psychiatrists guidance about how to treat diabetes, worrying that doing so would tarnish Zyprexa's reputation. "Although MDs like objective, educational materials, having our reps provide some with diabetes would further build its association to Zyprexa," a Lilly manager wrote in a March 2002 e-mail message.

But Lilly did expand its marketing to primary care physicians, who its internal studies showed were less aware of Zyprexa's side effects.

Lilly sales material encouraged representatives to promote Zyprexa as a "safe, gentle psychotropic" suitable for people with mild mental illness.

Some top psychiatrists say that Zyprexa will continue to be widely used despite its side effects, because it works better than most other anti-psychotic medicines in severely ill patients. But others say that Zyprexa appears no more effective overall than other medicines.

And some doctors who specialize in diabetes care dispute Lilly's assertion that Zyprexa does not cause more cases of diabetes than other psychiatric drugs. "When somebody gains weight, they need more insulin, they become more insulin resistant," Dr. Joel Zonszein, the director of the clinical diabetes center at Montefiore Medical Center in the Bronx, said when asked about the drug.

In 2003, after reviewing data provided by Lilly and other drug makers, the FDA said that the current class of anti-psychotic drugs may cause high blood sugar. It did not specifically single out Zyprexa, nor did it say that the drugs had been proven to cause diabetes.

The drugs are known as atypical anti- psychotics and include Johnson & Johnson's Risperdal and AstraZeneca's Seroquel. When they were introduced in the mid-1990s, psychiatrists hoped they would relieve mental illness without the tremors and facial twitches associated with older drugs. But the new drugs have not proven significantly better and have their own side effects, said Dr. Jeffrey Lieberman, the lead investigator on a federally sponsored clinical trial that compared Zyprexa and other new drugs with one older one.

The Zyprexa documents were provided to The Times by James B.

Gottstein, a lawyer who represents mentally ill patients and has sued the state of Alaska over its efforts to force patients to take psychiatric medicines against their will. Gottstein said the information in the documents raised public health issues.

"Patients should be told the truth about drugs like Zyprexa," Gottstein said.

Lilly originally provided the documents, under seal, to plaintiffs lawyers who sued the company claiming their clients developed diabetes from taking Zyprexa. Gottstein, who is not subject to the confidentiality agreement that covers the product liability suits, subpoenaed the documents in early December from a person involved in the suits.

In its statement, Lilly called the release of the documents "illegal." The company said it could not comment on specific documents because of the continuing product liability suits.

In some ways, the Zyprexa documents are reminiscent of those produced in litigation over Vioxx, which Merck stopped selling in 2004 after a clinical trial proved it caused heart problems. They treat very different conditions, but Zyprexa and Vioxx are not entirely dissimilar. Both were thought to be safer than older and cheaper drugs, becoming bestsellers as a result, but turned out to have serious side effects.

After being pressed by doctors and regulators, Merck eventually did test Vioxx's cardiovascular risks and withdrew the drug after finding that Vioxx increased heart attacks and strokes.

Lilly has never conducted a clinical trial to determine exactly how much Zyprexa raises patients' diabetes risks. But scientists say conducting such a study would be exceedingly difficult, because diabetes takes years to develop, and it can be hard to keep mentally ill patients enrolled in a clinical trial.

When it was introduced, Zyprexa was the third and most heralded of the atypical anti-psychotics. With psychiatrists eager for new treatments for schizophrenia, bipolar disorder, and dementia, Zyprexa's sales soared.

But as sales grew, reports rolled in to Lilly and drug regulators that the medicine caused massive weight gain in many patients and was associated with diabetes. For example, a California doctor reported that eight of his 35 patients on Zyprexa had developed high blood sugar, including two who required hospitalization.

The documents show that Lilly encouraged its sales representatives to play down those effects when talking to doctors. In one 1998 presentation, for example, Lilly said its salespeople should be told, "Don't introduce the issue!!!" Meanwhile, the company researched combinations of Zyprexa with several other drugs, hoping to alleviate the weight gain. But the combinations failed.

To reassure doctors, Lilly also publicly said that when it followed up with patients who had taken Zyprexa in a clinical trial for three years, it found that weight gain appeared to plateau after about nine months. But the company did not discuss a far less reassuring finding in early 1999, disclosed in the documents, that blood sugar levels in the patients increased steadily for three years.

In 2000 and 2001, more warning signs emerged, the documents show.

In four surveys conducted by Lilly's marketing department, the company found that 70 percent of psychiatrists polled had seen at least one of their patients develop high blood sugar or diabetes while taking Zyprexa, compared with about 20 percent for Risperdal or Seroquel.

Lilly never disclosed those findings.

By mid-2003, Lilly began to change its stance somewhat, publicly acknowledging that Zyprexa can cause severe obesity. Marketing documents make clear that by then Lilly believed it had no choice.

Since then, Lilly has acknowledged Zyprexa's effect on weight but has argued that it does not necessarily correlate to diabetes. But Zyprexa's share of antipsychotic drug prescriptions is falling, and some psychiatrists say they no longer believe the information Lilly offers.

"From my personal experience, at first my concerns about weight gain with this drug were very significantly downplayed by their field representatives," said Dr. James Phelps, a psychiatrist in Corvallis, Oregon. "Their continued efforts to downplay that, I think in retrospect, was an embarrassment to the company."

Phelps says that he tries to avoid Zyprexa because of its side effects but sometimes still prescribes it, especially when patients are acutely psychotic and considering suicide, because it works faster than other medicines.

"I wind up using it as an emergency medicine, where it's superb," he said. "But I'm trying to get my patients off of Zyprexa, not put them on."

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Drug maker played down risks of schizophrenia medication - Business - International Herald Tribune (Published 2006)

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NEW YORK - The drug maker Eli Lilly has engaged in a decade-long effort to downplay the health risks of Zyprexa, its best-selling medication for schizophrenia, according to hundreds of internal Lilly documents and e-mail messages among top company managers.

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Subject Expertise: "Effect of Adjunct Psychosocial Skills Training on Social Functioning of Schizophrenia Patients Who Get Occupational Therapy in a Community Mental Health Center: A Comparative Study" by the authors, Karaman, İmran Gökçen, et al. 

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Subject Expertise: "Effect of Adjunct Psychosocial Skills Training on Social Functioning of Schizophrenia Patients Who Get Occupational Therapy in a Community Mental Health Center: A Comparative Study" by the authors, Karaman, İmran Gökçen, et al. 

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Describes the side effects caused by anti-psychotics. Explores how medication affects Schizophrenia patients daily life and public persona. When doctors prescribe anti-psychotics, they need to put precautions in place to protect and fight against the side effects. Discusses the need for in place therapy to help with anti-social behaviors.
This supports my claim that a combination of both therapy and anti-psychotics are the best combination for treating Schizophrenia. Supports that anti-psychotics should not be taken alone. Schizophrenia patients need therapy in order to help with side effects.

"The distinct result obtained from the study is that the social functioning of schizophrenia patients, who received psychosocial treatment, improved and their clinical symptoms diminished".

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Subject Expertise:  "The Impact on Functioning of Second-Generation Antipsychotic Medication Side Effects for Patients with Schizophrenia: a Worldwide, Cross-Sectional, Web-Based Survey" ,written by Tandon, Rajiv, et al.  

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Subject Expertise:  "The Impact on Functioning of Second-Generation Antipsychotic Medication Side Effects for Patients with Schizophrenia: a Worldwide, Cross-Sectional, Web-Based Survey" ,written by Tandon, Rajiv, et al.  

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Describes a study regarding the side effects of anti-psychotics on Schizophrenia patients worldwide. Explores with multiple different tests and translations how Schizophrenia patients are feeling on their anti-psychotic. When given psychosocial treatment, their side effects lightened. Discusses the need for psychosocial treatment for patients on anti-psychotics.

This supports my claim that anti-psychotics should not be used alone, but in combination with psychosocial therapy. Supports the data that shows that side effects of anti-psychotics are major in patients daily life. Side affects of anti-pychotics need to be treated as well.

"Activating, sedating as well as metabolic and sexual side effects are associated with substantial impacts across all aspects of daily functioning (physical, social, vocational and emotional), as well as lower quality of life satisfaction".

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Subject Expertise: The Brain: The Story of You by David Eagleman

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Subject Expertise: The Brain: The Story of You by David Eagleman

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The author discusses how the brain functions and develops over time. With different environments, the brain can develop differently.
"Throughout our childhoods, our local environments refine our brain, taking the jungle of possibilities and shaping it back to what we're exposed to".

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Read 1,725 reviews from the world's largest community for readers. Locked in the silence and darkness of your skull, your brain fashions the rich narrative...

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Essay 4: Treatment for the Shifting Lines of Reality

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Essay 4: Treatment for the Shifting Lines of Reality

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Central Question: Is the combination of medication and therapy the most beneficial way to treat schizophrenia?
I found that most of the awful side affects caused by antipsychotic medication needed treatment as well. When antisocial tendencies appear and quality of life goes down, the use of cognitive or psychosocial therapy can help. Using the combination of both therapy and medication have been found to show the most success.