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Treatment (drugs...continued)


Drug forms

Tablets, liquid, short-acting or long-acting injectable.

Dosing

The response to antipsychotics is highly individual and variable with as much as a fortyfold difference among patients. Before prescribing any antipsychotic drug, the full prescribing information for the product should be consulted.

Drug side effects

"Antipsychotic drugs are among the safest group of drugs known. It is almost impossible to commit suicide with them by overdosing, and their serious side effects are comparatively rare...This is not to say that antipsychotic drugs are perfectly safe and have no side effects whatsoever. They do have side effects, sometimes so severe that the drug must be stopped...like side effects to all drugs used in medicine, it is not possible to predict ahead of time with any accuracy which person is likely to get which side effect." They are also nonaddictive. Unlike the case with some other classes of therapeutic agents, patients taking antipsychotic drugs do not appear to develop tolerance over time or withdrawal symptoms. The "zombie" stereotype of a medicated schizophrenic originated "in the fact that the symptoms of schizophrenia are often confused with the effects of the drugs used in its treatment." Furthermore, many patients in state hospitals appear to be undermedicated rather than overmedicated.

Tardive Dyskinesia

"The condition usually develops in schizophrenics who are older and who have been on antipsychotic drugs for many years." This side effect is characterized by involuntary movements of the tongue and mouth, sometimes of the arms and legs; it is more common in women than men.

"The frequency and seriousness of tardive dyskinesia is one of the most hotly debated topics in current psychiatry. Estimates of frequency are confounded by the fact that the movements of tardive dyskinesia can be caused by schizophreenia, as well as by the drugs used to treat it. Kraeplin described such movements as early as 1904... The most informed estimate to date is that 13% of chronic schizophrenic patients suffer from some degree of drug induced dyskinesia." In the majority of cases, the symptoms abate if detected early and the medication is discontinued.

Psychotherapy

Practical, supportive psychotherapy, whether individual or group, which offers friendship, advice, help with everyday living management can be a useful adjunct to drug therapy.

"There is scientific evidence that such a supportive relationship, when it is used in addition to drug therapy, is helpful in reducing the rehospitalization for schizophrenia."

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