What are the goals of treatment?
Before starting the long-term treatment, the hospital team (including the psychiatrist, psychologist, nurses and social worker) sets goals together with the person affected by schizophrenia . It is beneficial to involve the patients’ families in the therapy as soon as possible.
The goals may vary from person to person. At the beginning the main goal is to find the balance again through steps, like:
- decreasing or eliminating symptoms
- preventing relapse and hospitalization
- easing or eliminating the possible side effects of the treatment
As the balance is reached, more ambitious goals can be set, which help people to return to the life the used to live before the onset of the illness, such as:
- getting back to the school or work
- living an independent life
- rebuilding personal relationships
The early diagnosis and effective treatment is crucial to reach the best outcomes possible
Schizophrenia is a disease that starts young, so it affects youngsters studying or being at the beginning of their work career. The psychotic episodes and other symptoms of schizophrenia can disrupt studies and work, so the early effective therapy can make a huge difference, affecting their entire life. It is worth to act early, because the proper treatment can make it possible even to return to the way of living before schizophrenia.
Medications: the options
The medications for the long-term treatment of schizophrenia can be divided into 2 main types of formulations: tablets that have to be taken every day, and long-acting injections that can be administered biweekly, monthly or 3-monthly. All available therapeutic options are highly effective, but only if they are taken/administered regularly as prescribed.
What happens in reality?
After hospitalization for the first psychotic episode families try to bring balance into the patients’ lives with the daily tablets prescribed by the doctor at discharge. But due to multiple factors caused by the illness it is usually very hard to reach that balance: 54% of patients do not collect the antipsychotic prescription or use their initial antipsychotic medication for less than a month.1 This pattern will likely lead to relapse into subsequent psychotic episodes time after time.2 One of the most common causes of relapse is that people stop taking the prescribed medication.6
Is there an alternative solution?
Yes, there is. Long-acting antipsychotics have been developed to reduce the chances of relapse due to treatment discontinuation.6 Long-acting formulations, that can be administered less frequently, are becoming a more common and convenient solution in other medical fields as well such as rheumatology, dermatology, and immunology. In schizophrenia the daily tablets can be replaced with injections given biweekly, monthly or 3-monthly. Research shows that the risk of relapse and hospitalization is significantly lower during the long-acting treatment, than with daily tablets.3
Would you/your loved one accept this type of medication?
Results of a survey from 166 patients with schizophrenia and 468 caregivers from 12 European countries showed that 68% of patients treated with oral antipsychotics confirmed they would consider switching to a long-acting antipsychotic treatment, though 32% reported they have not been made aware of it as an option.5 There are some beliefs that patients do not like the injections. Patients usually accept injections if they are properly informed on the pros and cons of the long-acting injectable therapy.4
Knowing all this, which option would you choose?7
|An oral tablet every day
||An injection in the arm or buttock once a month with the opportunity of the 4-times a year treatment - based on your doctor’s judgement
|Your responsibility is to remember to take the tablet every day
||Your responsibility is to keep your appointment to visit your psychiatrist once a month or 3-months
|If you forgot to take, or deliberately skip your daily dose, the likelihood of relapse increases
||If you do not keep your appointment to visit your psychiatrist for your monthly/3-mothly injection, the likelihood of relapse increases
Talk to your psychiatrist about the therapeutic options to find the best solution for you and your loved one.
Please find here 2 questionnaires, one for patients and one for relatives that may help the discussion with your doctor.