Schizophrenia is a group of disorders that develop chronically of unknown etiology. The main clinical manifestations of thinking disorders, sensory impairments, emotional disorders, behaviors and other obstacles, this disease seriously affects social function, reasonable symptomatic medication, treatment course and adequate medication is the key to successful treatment of the disease. The following Yue Liang said that the medicine will make a simple summary of the principles of medication treatment for schizophrenia and the characteristics of various schizophrenia medications, hoping to help everyone use drugs rationally.
1. In the acute phase, antipsychotic drugs should be used as the preferred treatment measures. Acute onset in this period, positive symptoms are the mainstay, medication relieves the main symptoms, and prevents suicide and impulsive behaviors that endanger society. The course of treatment is 4-6 weeks. Principles of drug selection: consider factors such as efficacy, safety, adherence to long-term treatment, and efficacy-price (dose-price) ratio
2. Recovery period (consolidation period): to prevent the recurrence of symptoms that have been relieved. Continue treatment with the original medication and dosage for 3-6 months.
3. Maintenance period: prevent repeated diseases and help patients return to society. The dose can be reduced for 3-5 years. Annexed maintenance programme recommendations:
(1) After the acute symptoms are controlled, maintenance treatment is maintained for at least one year
(2) Reduction method: Reduce by 10% every six weeks until the lowest effective maintenance amount is found. Usually 1/3-1/2 of the effective dose.
(3) For the first initial patient, if there are no positive symptoms and signs of recurrence, you can try to stop the drug observation program, but there is still a potential risk of recurrence, which needs to inform the patient and agree to this program before it can be implemented.
(4) If patients with a history of recurrence of schizophrenia are recommended for long-term maintenance therapy, generally 3 to 5 years of stable condition, drug reduction can be considered.
1. Quetiapine tablets ——— used to treat schizophrenia, or bipolar positive symptoms such as manic episodes.
2. Fennajing ——— has a good effect on hallucinations, delusions, thinking disorders, anxiety and agitation and other symptoms. It can also be antiemetic and anti-vomiting.
3. Shupilide ——— widely used in various types of schizophrenia, such as simple type, paranoid type, tension type, etc., can improve the symptoms of isolation, withdrawal and apathy. It has a certain effect on depressive symptoms. It also has anti-nausea effects.
4. Olanzapine ——— broad-spectrum anti-schizophrenia drugs, suitable for acute phase and maintenance treatment of schizophrenia and other psychosis with severe positive symptoms and / or negative symptoms.
5. Aripiprazole ——— used in the treatment of schizophrenia. It is generally effective in short-term (4 weeks and 6 weeks) in patients with schizophrenia.
6. Amisulpride ——— suitable for acute and chronic schizophrenia treatment, often used for negative symptoms (such as emotional apathy, slow response, and social ability withdrawal) or positive symptoms (such as hallucinations, cognitive impairment) can also be used for schizophrenia characterized by negative symptoms.
7. Ziprasidone ——— broad-spectrum anti-schizophrenia drug.
8. Bunanserin tablets ——— broad-spectrum anti-schizophrenia drugs.
9. Chlorpromazine ——— is mainly good enough for positive symptoms, such as agitation, hallucinatory delusions, thinking disorders, etc. Commonly used for schizophrenia, mania, or other psychotic disorders.
10. Risperidone ——— used for acute and chronic schizophrenia, and has a certain effect on positive symptoms (such as hallucinations, delusions, thought disorders, hostility, suspicion) and obvious negative symptoms (such as: slow response, emotional apathy and social apathy, little language), and a simple understanding of broad-spectrum anti-schizophrenia is used.
11. Clozapine ——— is suitable for various subtypes of acute and chronic schizophrenia, and has a good effect on hallucinatory delusional type and adolescent type. It can also alleviate the emotional symptoms associated with schizophrenia (e.g., depression, guilt, anxiety).
12. Haloperidol ——— broad-spectrum anti-schizophrenia drugs. Effective for mania and Tourette's syndrome. It can control agitation, hostile emotions and aggressive behavior better. The incidence of adverse reactions in cardiovascular and cerebrovascular diseases is small enough, and it is often used for cerebral organic mental disorders and senile mental disorders.
13. Lurasidone tablets ——— broad-spectrum anti-schizophrenia drugs.
14. Paliperidone extended-release tablets ——— mostly used in the treatment of acute stages of schizophrenia.
15. Haloperidol melitrexine tablets ——— are often used for mild to moderate depression, anxiety, neurasthenia, menopausal depression, but also for anxiety and depression in alcoholics and drug addicts.
Schizophrenia is not terrible, the main rational use of drugs, foot treatment can generally be cured. For drug selection, practice effectiveness without changing prescriptions, the shortest effective time of appropriate dose treatment should be 4 to 6 weeks, if it is ineffective, the drug can be changed, and the principle of individualized medication should be followed: oral medication should start in small doses, slowly increase the amount, the lowest effective dose (maximum efficacy, least side effects), do not pursue excessive control of symptoms and oversized doses.
If the patient continues to experience symptoms such as anxiety, depression, and hostility, adjuvant medication is appropriate.
(1) Persistent anxiety can be added with benzodiazepines and anthropocene
(2) Persistent depression, antidepressants should be added
(3) Persistent hostility and manic-like symptoms can be added with lithium salts or carbamazepine
After adequate dose and course of treatment, the efficacy is not good, such as positive symptoms are controlled, negative symptoms persist, patient compliance is good, but still relapse; patients cannot tolerate adverse reactions.
Before taking the drug, the three major routines, liver, kidney and heart function should be routinely checked, and the drug should be reviewed regularly during the process of taking the drug, and the general medication needs to be reviewed by the hospital for 3 months. Follow-up such as various indicator policies, you can review once every 6 months under the guidance of a doctor.
Through the above-mentioned introduction of how to rationally use drugs for schizophrenia and the characteristics of various drugs, I believe that everyone has a certain understanding of schizophrenia-related drug treatment. Please follow your doctor's instructions, follow the course of medication, do not suspend medication because you feel good about yourself or because of adverse drug reactions, and communicate with your primary care physician when there is an adverse reaction or unclear symptoms when using the drug. Pay attention to @YueLiang medicine and share with you more knowledge of medication for mental illness.
bibliography: First, the Chinese Pharmacopoeia drug instructions II. Mims Guidelines for The Use of Neurological and Psychiatric Disorders (Sixth Edition)