Treatment methods for schizophrenia in men

Treatment methods for schizophrenia in men are not different from those for women, but men are more often more severely ill, and accordingly, their treatment requires more powerful neuroleptics in higher doses. In all cases, basic therapy with neuroleptics is used, the choice of drug is based on the analysis of the peculiarities of the manifestation of productive symptoms and the form of the course of the disease. Other methods, such as insulin coma and electroconvulsive therapy, are also used. [1]

In the acute period, active drug therapy is used, after achieving therapeutic effect, the patient is transferred to supportive therapy with the prescription of the minimum effective dose of drugs in order to prevent exacerbations and increase the stabilization interval. [2]

The most severe form of the disease, juvenile malignant continuous schizophrenia, is treated with powerful antipsychotic drugs that can weaken and nullify severe catatonic, hebephrenic, paranoid and mixed symptoms. In such cases, high dosages of neuroleptics are prescribed, exceeding the standard dosages twice or even five times. This contributes, in most cases, to a significant reduction in the manifestations of psychosis.

Aminazine remains the drug of choice. It is prescribed at 0.6-0.8g per day. Azaleptin (in a daily dose of 0.3-0.4g), Propazine (0.35g), Tizercin 0.2-0.3g), Haloperidol or Majeptil (0.03-0.04g), Trisedil (0.01-0.015g) are also used. The choice of drug is based on its efficacy and sensitization to it in the patient.

The action of classical neuroleptics is based on the effect on the dopamine system, due to which they effectively cope with delusional-hallucinatory symptoms, eliminate paranoid and manic thoughts, buy psychomotor agitation, calm aggressive impulses.

At the same time, these drugs have many side effects on virtually all organs and systems. In addition to causing relatively "harmless" symptoms such as dry mouth, heartburn, diarrhea, nausea, drowsiness, allergic rashes, they disrupt heart function, cause dysuric disorders and inflammation of the liver, and can cause anaphylaxis, basically like other drugs. Drugs with antipsychotic action also cause neuroleptic syndrome associated with their action on the brain, the leading symptom of which becomes hyper- or hypokinesia, additional - anxiety, agitation, seizures and other disorders of the central nervous system, essentially changing one mental disorder to another. [3]

To neutralize severe complications that often develop during treatment with neuroleptics, patients are prescribed drugs-correctors (antiparkinsonian): cholinolytics of central and peripheral action with myorelaxing effect Cyclodolol in a daily dose of 0.012-0.014g; central cholinolytics Akineton; nootropics.

Prolonged antipsychotic therapy is addictive, which reduces its effectiveness. A variety of techniques are used to intensify treatment. For example, sudden interruption of antipsychotic therapy followed by resumption of treatment is practiced.

The positive response to the action of neuroleptics strengthens the use of immunostimulants. In the hospital twice a week, the patient is prescribed injections of Decaris (0.15g each). Orally may be prescribed Dimefosfon three times a day at a rate of 0.03g per kilogram of patient weight.

In addition to antipsychotic use forced insulin coma therapy - drip insulin administration before the onset of insulin coma. The course of treatment is from 25 to 30 procedures. [4]

Simple juvenile schizophrenia is treated with classical neuroleptics with psychostimulant effect. Triptazine in a daily dose of 0.02-0.025g, Etaperazine (not more than 0.03g), Majeptil (not more than 0.015g) and others are prescribed.

Atypical neuroleptics, considered less dangerous in terms of complications from their action, are also used: Risperidone in a daily dose of up to 0.004g; [5] Olanzapine (up to 0.015g); Seroquel (up to 0.9g). New generations of drugs act not only on the dopaminergic system of the brain, but also on the serotoninergic system, which reduces the likelihood of neuroleptic syndrome, but does not exclude it altogether. In addition, such side effects as obesity and diabetes mellitus, as well as stroke, develop after taking atypical neuroleptics much more often than classical neuroleptics. [6], [7], [8]

Typical neuroleptics are also chosen for the treatment of paranoid continuous schizophrenia, the leading symptom of which is delirium and hallucinations. Schizophrenics with a predominant delirium component are prescribed Etaperzine in a daily dose of 0.06g to 0.09g, Triftazine - approximately 0.04-0.05g, Haloperidol (0.02-0.03g), hallucinatory - lower doses of Etaperzine (0.035-0.04g) or Triftazine (0.03-0.035g). Of atypical neuroleptics, Azaleptin is preferred. It is prescribed in a daily dose of up to 0.3g. In general, drugs are selected individually, as well as dosages. It is necessary to cause a satisfactory therapeutic effect and avoid serious side effects as much as possible, for which the doctor needs constant contact with the patient. [9]

In the late stages of paranoid schizophrenia, when the patient's body no longer responds properly to classical therapy with neuroleptics, injectable forms are used, such as the long-acting drug Fluphenazine (Moditen-depo). One intramuscular injection (0.025-0.075g) is made at intervals of a week to a month (individually, empirically, depending on the rate of release of the active ingredient). The drug has a strong antipsychotic effect, exceeding the effect of Aminazine (reference), and has a lower probability of neuroleptic syndrome and somatic complications. It is also successfully used for the treatment of juvenile malignant schizophrenia.

Paranoid schizophrenia also responds well to injection therapy with Clopixol, one of the relatively new neuroleptics. It is injected deep into the muscle at a daily dose of 0.1g. It is effective both in the debut of a paranoid attack and in the treatment of relapse. Olanzapine is also used. These drugs, in addition to controlling the productive symptomatology, mitigate the negative manifestations.

Sometimes combinations of neuroleptics, such as Clopixol-depo and Piportil L4, are used to stabilize the condition and create a prolonged period of remission.

In the treatment of schizophrenia, the aim is to stop the acute attacks of affective delusional psychosis. For this purpose, insulin-comatose therapy is used (at manifestation of the disease) or combined (especially in relapses): antipsychotic therapy with the use of Leponex (0.3g per day), Propazine (0.35g), Tizercin (0.2g) in combination with the administration of antidepressants - classic tricyclic Amitriptyline in a daily dose of up to 0.3g, Anafranil (up to 0.3g) or Ludomil (up to 0.2g). The choice of drug depends on the affect structure. If the manic component is predominant, antipsychotics are combined with lithium.

Schizotypal disorder (sluggish schizophrenia) usually requires prescription of neuroleptics in lower doses, both typical and atypical, in combination with tranquilizers. It is recommended to include in the treatment regimen drugs-biotics that improve metabolic processes in the brain, increase stress resistance and performance, glycine or biotredine in a daily dose of up to 0.8g. In low-progressive forms of schizophrenia may in some cases help cognitive behavioral therapy even without the use of antipsychotics.

Nutrition in schizophrenia in men

In principle, schizophrenics can eat any food, no diet is required by the disease. However, there is an opinion that a certain style of eating can contribute to the appearance of schizophreniform symptoms. This opinion is shared by many physicians. In general, nutrition in schizophrenia should be quite full, varied, healthy and tasty. It is only necessary to observe some restrictions.

It is doubtful whether dietary correction alone can cure true schizophrenia, but there must be undoubted benefit in any case.

In schizophrenia, the biochemical processes occurring in the brain are altered, and there are foods that can affect metabolism. Therefore, if you follow certain nutritional principles, you will definitely not get worse.

The anti-schizophrenia diet recommends practically not consuming foods that contain casein and gluten. The largest amount of casein is contained in milk, goat and cow milk, a lot of it in cheese and other dairy products. It is an easily digestible protein that people need for muscle and bone growth. However, in schizophrenics, especially if there is acquired with age lactose intolerance, these products will provoke not only digestive disorders, and attacks of schizophrenia. A patient with excessive casein may complain of blurred vision, dizziness, he will often have anxiety and dysphoric disorders. Schizophrenics should not completely refuse dairy products, but it is better to consume them in a squashed form (kefir, ryazhenka, sour cream, natural yogurt) and no more than one glass per day, the use of cheese (cottage cheese) is limited to 30-gram portions three times a week.

Schizophrenics and those predisposed to the disease should watch their intake of sweets, i.e. Foods high in sugar, and control blood glucose levels by keeping them normal. Do not completely eliminate sweets, but do not overeat. For example, sweet carbonated drinks should be removed from the diet altogether, you can do without store juices in cardboard boxes, cakes, pastries, candies also do not belong to the healthy food. You can not eat honey and jam by tablespoons, fruits and berries with a high sugar content - kilograms. In our lands - these are grapes, cherries, sweet apples, from the exotics - figs, lychees, mangoes, pineapple. At the same time, it is better to replace sugar with a small amount of honey, dried fruits, berries. It is not necessary to completely refuse from sweets, just control its consumption.

Gluten is found in cereals. These are cereals and all kinds of baked goods. If gluten-containing foods are excluded from the diet, there is an improvement in the condition of patients, the attacks pass with lighter symptoms, and remission comes faster.

Dietary changes should be made in the direction of greater consumption of mono- and polyunsaturated fatty acids, which take part in the renewal of all cell membranes, including brain neurons. These are vegetable oils: sunflower, corn, olive, linseed, rapeseed, seafood and shellfish, fish and fish oil, nuts, flax seeds, pumpkin seeds, sesame seeds, sprouted grains, green vegetables. There is a great variety of such products.

Saturated fatty acids are found in meat, offal and butter. These foods can and should be eaten, but not too much. For example, lean red meat - once a week, with a side dish of vegetables (but not potatoes), butter - about five grams per day.

Foods with antidepressant properties - fish (salmon), seaweed, almond nuts, turkey and rabbit meat, bananas, blueberries, strawberries will help improve mood and reduce anxiety.

In the diet should be vitamins, antischizophrenic activity has ascorbic acid (onions, fresh vegetables, berries and fruits), B vitamins (eggs, meat, liver, legumes, green vegetables, fish, potatoes, tomatoes), vitamin E (vegetable oils, olives, seeds, nuts, apricots).

In addition, if possible, you should consume natural organic products. In the diet should be more vegetables and fruits, fresh, in winter - fresh-frozen. Bread is preferable whole-grain or rye and in limited quantities. No alcohol, coffee and strong tea, the same applies to sausages, smoked meats and pickles. Of porridge preference oatmeal, buckwheat, millet. It is recommended to consume bran and sprouted wheat grains. Daily eat nuts and seeds from 20 to 50g.