Treatment methods for schizophrenia in men

Treatment methods for schizophrenia in men are no different from those for women, men simply tend to get sick more severely, and accordingly, their treatment requires more powerful neuroleptics in higher doses. In all cases, primary therapy with neuroleptics is used, the choice of drug is based on the analysis of the features of the manifestation of productive symptoms and the form of the disease. Other methods are also used, for example, insulin comatose and electroconvulsive therapy. [ 1 ]

In the acute period, active drug therapy is used; after achieving a therapeutic effect, the patient is transferred to maintenance therapy with the prescription of the minimum effective dose of the drug 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 reduce to nothing severe catatonic, hebephrenic, paranoid and mixed symptoms. In such cases, high doses of neuroleptics are prescribed, exceeding the standard by two or even five times. This contributes, in most cases, to a significant weakening of the manifestations of psychosis.

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

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

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

To neutralize severe complications that often develop during treatment with neuroleptics, patients are prescribed corrector drugs (antiparkinsonian): central and peripheral anticholinergic with a muscle relaxant effect Cyclodol in a daily dose of 0.012-0.014 g; central anticholinergic Akineton; nootropics.

Long-term antipsychotic therapy causes addiction, which reduces its effectiveness. To intensify treatment, various methods are used. For example, sudden interruption of antipsychotic therapy with subsequent resumption of treatment is practiced.

A positive response to neuroleptics is enhanced by the use of immunostimulants. In hospital, the patient is prescribed Decaris injections (0.15 g) twice a week. Dimephosphone can be prescribed orally three times a day at a rate of 0.03 g per kilogram of the patient's weight.

In addition to antipsychotic therapy, forced insulin comatose therapy is used – drip administration of insulin until the onset of insulin coma. The course of treatment is from 25 to 30 procedures. [ 4 ]

Simple juvenile schizophrenia is treated with classical neuroleptics that have a psychostimulating effect. Triftazin is prescribed in a daily dose of 0.02-0.025 g, Etaperazine (no more than 0.03 g), Majeptil (no more than 0.015 g) and others.

Atypical neuroleptics are also used, which are considered less dangerous in terms of complications from their action: Risperidone in a daily dose of up to 0.004 g; [ 5 ] Olanzapine (up to 0.015 g); Seroquel (up to 0.9 g). New generation drugs act not only on the dopaminergic system of the brain, but also on the serotonergic system, which reduces the likelihood of developing neuroleptic syndrome, but does not exclude it altogether. In addition, side effects such as obesity and diabetes, as well as stroke, develop after taking atypical neuroleptics much more often than classical ones. [ 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 delusional component are prescribed Etaperzine in a daily dose of 0.06 g to 0.09 g, Triftazin - approximately 0.04-0.05 g, Haloperidol (0.02-0.03 g), hallucinatory - lower doses of Etaperzine (0.035-0.04 g) or Triftazin (0.03-0.035 g). Of the atypical neuroleptics, preference is given to Azaleptin. It is prescribed in a daily dose of up to 0.3 g. In general, drugs are selected individually, as are 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 neuroleptic therapy, injectable forms are used, for example, the prolonged-release drug Fluphenazine (Moditen-depot). One intramuscular injection (0.025-0.075 g) is given at intervals of a week to a month (individually, empirically, depending on the rate of release of the active substance). The drug has a strong antipsychotic effect, exceeding the effect of Aminazine (standard), and has a lower probability of developing neuroleptic syndrome and somatic complications. It is also successfully used to treat forms 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 in a daily dose of 0.1 g. It is effective both at the onset of a paranoid attack and in the treatment of a relapse. Olanzapine is also used. These drugs, in addition to relieving productive symptoms, also mitigate negative manifestations.

Sometimes, to stabilize the condition and form a long period of remission, combinations of neuroleptics are used, for example, Clopixol-depot and Piportil L4.

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

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

Nutrition for schizophrenia in men

In principle, schizophrenics can eat any food, the disease does not oblige them to any diets. However, there is an opinion that a certain style of nutrition can contribute to the appearance of schizophreniform symptoms. This opinion is shared by many doctors. In general, nutrition for schizophrenia should be quite complete, varied, healthy and tasty. You just need to follow some restrictions.

It is doubtful that true schizophrenia can be cured by dietary correction alone, but there should be undoubted benefits in any case.

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

The anti-schizophrenic diet recommends to practically not consume products containing casein and gluten. The largest amount of casein is contained in milk, goat and cow, there is a lot of it in cheeses and other dairy products. This is an easily digestible protein necessary for people to grow muscle and bone tissue. However, in schizophrenics, especially if there is an intolerance to lactose acquired with age, these products will provoke not only digestive disorders, but also attacks of schizophrenia. With an excess of casein, the patient may complain of blurred vision, dizziness, he will often have anxiety and dysphoric disorders. Schizophrenics should not completely give up dairy products, but it is better to consume them in fermented form (kefir, fermented baked milk, sour milk, natural yogurt) and no more than one glass per day, the consumption of cheeses (cottage cheese) is limited to 30-gram portions three times a week.

Schizophrenics and people predisposed to the disease should monitor their consumption of sweets, that is, products with a high sugar content, and control the glucose level in the blood, keeping it within the norm. Do not completely eliminate sweets, but do not overeat. For example, sweet carbonated drinks should be completely removed from the diet, you can do without store-bought juices in cardboard boxes, cakes, pastries, and candies are also not considered healthy food. You do not have to eat honey and jam by the tablespoon, fruits and berries with a high sugar content - by the kilogram. In our area - these are grapes, cherries, sweet apples, exotic - figs, lychee, mango, pineapple. At the same time, it is better to replace sugar with a small amount of honey, dried fruits, berries. You do not need to completely give up sweets, just control their consumption.

Gluten is found in cereals. These are porridges and all kinds of baked goods. If gluten-containing products are excluded from the diet, then the condition of patients improves, attacks occur with milder symptoms, and remission occurs faster.

The diet should also be changed towards greater consumption of mono- and polyunsaturated fatty acids, which participate in the renewal of all cell membranes, including neurons in the brain. These are vegetable oils: sunflower, corn, olive, flaxseed, rapeseed, seafood and shellfish, fish and fish oil, nuts, flax seeds, pumpkin, sesame, sprouted grains, green vegetables. There are a great many such products.

Saturated fatty acids are found in meat, offal, and butter. These products can and should be consumed, but not overeaten. For example, lean red meat once a week, with a vegetable side dish (but not potatoes), butter – about five grams per day.

Products with antidepressant properties – fish (salmon), seaweed, almonds, turkey and rabbit meat, bananas, blueberries, strawberries will help improve your mood and reduce anxiety.

The diet should contain vitamins; 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, dried apricots) have anti-schizophrenic activity.

In addition, if possible, you need to eat natural, environmentally friendly products. The diet should include more vegetables and fruits, fresh, in winter - freshly frozen. Bread is preferably whole grain or rye and in limited quantities. No alcohol, coffee or strong tea, the same applies to sausages, smoked and pickled foods. Of cereals, preference is given to oatmeal, buckwheat, millet. It is recommended to eat bran and sprouted wheat grains. Eat nuts and seeds daily from 20 to 50 g.