Treatment of schizophrenia in women

The question is often asked: is schizophrenia curable in women? It is not curable, neither in women, nor in men, nor in children. So far this disease is incurable, and even with successful achievement of long-term remission, a return of the acute condition is possible. However, with timely assistance, it is possible to achieve such a long remission that it can be equated to recovery.

There are no special methods of treating schizophrenia in women. People of any gender and age who are diagnosed with schizophrenia are primarily prescribed drug therapy. Many patients take medications throughout their lives. Such maintenance therapy allows them to live a virtually normal life.

In most cases, the first request for help occurs during an acute attack of schizophrenia, when the symptoms of psychosis are expressed quite clearly. More often, it is not the patients themselves who seek help, but their relatives. Urgent hospitalization is required for a state of psychomotor agitation.

In milder cases, both relatives and the patient herself may seek medical attention. Outpatient treatment may often be indicated.

There are many problems in treating such patients. They may not want to be treated, and not considering themselves ill, ignore doctor's orders, may simply forget to take medications, however, their condition directly depends on compliance with the regimen prescribed by the doctor.

Since the pathogenesis of schizophrenia is not yet reliably known, symptomatic treatment is carried out. The main drugs are neuroleptics, with the advent of which a new era in the treatment of schizophrenia began, since all of them are effective in relation to productive symptoms, stabilize mood, and new generation drugs, as studies show, normalize the size of the basal ganglia. Their effect is still being studied and new findings are possible.

Medicines of different generations are used, all of them have a wide range of side effects. Patients also react to them individually. It is not always possible to choose the right medicine the first time, sometimes you have to try several names before finding the right remedy.

Aminazin, the first drug of this class, is still quite relevant in the treatment of schizophrenia and, especially, the acute state of the disease. The antipsychotic effect of the drug is realized by blocking the central dopaminergic and α-adrenoreceptors. Its main feature is a pronounced calming effect, the strength of which is directly proportional to the dose of the drug. Aminazin inhibits all types of motor activity, but especially those related to motor-defensive conditioned reflexes, relaxes skeletal muscles, and reduces blood pressure. Under its influence, the patient's body is in a state close to physiological sleep. The drug does not have the effect of narcotic substances, awakening does not cause difficulties for the patient. It effectively eliminates productive symptoms and has a positive effect on the emotional background.

In addition to Aminazine, Haloperidol is used from the early antipsychotics for the treatment of schizophrenia. It acts on the same groups of receptors as the previous drug. Typical antipsychotics are able to quickly relieve productive symptoms, relieve anxiety and improve the mood and emotional status of the patient. Medicines of this group have the ability to influence the frequency and intensity of the generation of nerve impulses in different parts of the central nervous system and their transmission to the periphery. They are able to influence metabolic processes in the cerebral cortex, respectively, this ability is associated with the neuroplegic side effects they cause - muscle numbness, constant muscle spasms, tremors in the limbs and other extrapyramidal reactions. Enhances the effect of other sedatives, inhibits various reflex activities that ensure the physiological processes of homeostatic regulation of the functions of internal organs.

Later drugs, the so-called atypical neuroleptics, have virtually no side effects such as extrapyramidal disorders. Clozapine, the first of this group, is widely used to treat schizophrenia, especially in cases resistant to traditional therapy. Subsequent drugs (Seroquel, Risperidone), when taken in high doses, also belonging to the atypical class, cause extrapyramidal syndromes more often than Clozapine. The active substance of the drug is a tricyclic derivative of dibenzodiazepine, one of its metabolites is benzodiazepine, which provides a powerful anxiolytic effect.

In the treatment of schizophrenia, Clozapine achieves a therapeutic effect in most cases much faster than its classmates. It has a pronounced antipsychotic, antidepressant and sedative effect, as well as a moderate antimanic effect. It is effective for the treatment of individuals with acute depersonalization, showing suicidal intent and/or uncontrolled aggression. In relation to the effect on cognitive abilities, the results of trials provide contradictory data: in some cases, researchers note a positive effect, in others - a negative effect. A serious side effect of Clozapine is a significant decrease in the level of leukocytes in the blood (agranulocytosis), so regular monitoring of blood composition is required during therapy with this drug. It is this dangerous property of the drug that makes it a reserve remedy, used only in cases where other drugs – Seroquel, Risperidone, Sertindole, which do not cause agranulocytosis and, less often than typical neuroleptics, lead to the development of extrapyramidal reactions, are ineffective.

A comparatively new atypical neuroleptic, Aripiprazole, is also used to treat schizophrenia. It is effective in relieving productive symptoms, especially when the patient has manic manifestations. Its pharmacological properties are still being studied, but it is known that the drug is well tolerated and provides a low frequency of side effects (extrapyramidal, hyperprolactinemia, weight gain, cardiovascular dysfunction, etc.), which is of great importance when long-term (constant) use is required.

Absolute contraindications to the use of antipsychotics are severe systemic pathologies of the brain and spinal cord, inflammatory and degenerative diseases of the liver and kidneys, decompensated heart disease, hematopoiesis disorders, myxedema, and vascular thrombosis.

The dosage of the drugs is individual, it is not recommended to deviate from the treatment regimen proposed by the doctor. If the course is interrupted, a withdrawal syndrome occurs, so the drug should be discontinued gradually and under the supervision of a doctor. You cannot change the dosage on your own.

If the patient has symptoms of depression, antidepressants are added to the treatment regimen. In the presence of concomitant diseases, appropriate therapy is prescribed based on known drug interactions.

Patients with a condition compensated for by taking neuroleptics are prescribed a course of psychosocial therapy, which helps in solving many problems that patients encounter. They have communication and motivational difficulties, problems with self-care and work. Sessions with a psychologist will help the patient adapt to society after intensive treatment. In addition, patients covered by the psychosocial rehabilitation program more conscientiously follow the doctor's recommendations, suffer less from exacerbations and end up in a psychiatric hospital. Receiving information from a psychotherapist about their disease, modern principles of its treatment and the importance of taking medications, patients can make a fully conscious and balanced decision regarding the need for medical supervision, as well as learn to independently relieve constant symptoms and recognize the harbingers of exacerbations and prevent them.