The first thing to emphasize is that the first onset of schizophrenia is the key to treatment, because this is when antipsychotic medication is most effective and requires a small dose, and if effective treatment is obtained, the patient has the best chance of recovery and the best long-term prognosis. Therefore, the treatment of first-onset patients needs to be taken seriously. Secondly, the treatment of schizophrenia should emphasize the early use of antipsychotic drugs and the full amount and duration of treatment.
The course of schizophrenia treatment.
1. Acute phase treatment: Acute treatment, in which an effective dose is achieved within the first 2 weeks of treatment with medication until symptoms are controlled, generally takes 6 to 8 weeks. The goal of treatment during this period is to try to reduce and alleviate acute symptoms and to rebuild and restore the patient’s social function.
2.Recovery period treatment: consolidation treatment, continue the effective dose of acute treatment, consolidation treatment generally takes 3-6 months, the goal of treatment in this period is to reduce the stress on the patient, reduce the possibility of relapse and enhance the patient’s ability to adapt to social life.
3.Stabilization treatment: that is, maintenance treatment.
The dose of maintenance treatment is usually lower than the effective dose. The maintenance dose of classical antipsychotics can be reduced to about 1/2 of the effective dose, and the new generation of atypical antipsychotics (except clozapine) are usually maintained at or slightly below the effective therapeutic dose.
There is no currently accepted standard for the duration of maintenance therapy, but the need for maintenance therapy is well established.
–John Kane advocates 5 years for first-episode patients and lifetime for relapsed patients.
–Csernansky believes that schizophrenic patients should be treated for life.
–Ben (1981) proposed that the duration of maintenance treatment varies from person to person: for acute onset, brief duration of symptoms (less than three months), and rapid remission of symptoms without fluctuation after prompt systematic treatment, about 6 to 12 months; first onset should be maintained for 2 to 3 years; second onset should be maintained for 5 years; those with 3 or more episodes or those whose symptoms never completely resolve with various treatments should be considered for lifelong Maintenance treatment.
–American Textbook of Comprehensive Psychiatry, Seventh Edition: 1 to 2 years for first episode; at least 5 years for multiple episodes; longer for those with suicidal, violent or aggressive behavior.
The purpose of drug maintenance treatment: to prevent relapse, improve the patient’s quality of life (including the treatment of negative symptoms), alleviate or reduce side effects.
4. Discontinuation: slow and gradual reduction of dosage until discontinuation.
Course of treatment.
1.Acute phase of treatment: Acute treatment, the effective dose is achieved within the first 2 weeks of treatment with the drug until the symptoms are controlled, which usually takes 6 to 8 weeks. The goal of treatment in this period is to try to reduce and alleviate acute symptoms and to rebuild and restore the patient’s social function.
2.Recovery period treatment: consolidation treatment, continue the effective dose of acute treatment, consolidation treatment generally takes 3-6 months, the goal of treatment in this period is to reduce the stress on the patient, reduce the possibility of relapse and enhance the patient’s ability to adapt to social life.
3.Stabilization treatment: that is, maintenance treatment.
The dose of maintenance treatment is usually lower than the effective dose. The maintenance dose of classical antipsychotics can be reduced to about 1/2 of the effective dose, and the new generation of atypical antipsychotics (except clozapine) are usually maintained at or slightly below the effective therapeutic dose.
There is no currently accepted standard for the duration of maintenance therapy, but the need for maintenance therapy is well established.
–John Kane advocates 5 years for first-episode patients and lifetime for relapsed patients.
–Csernansky believes that schizophrenic patients should be treated for life.
–Ben (1981) proposed that the duration of maintenance treatment varies from person to person: for acute onset, brief duration of symptoms (less than three months), and rapid remission of symptoms without fluctuation after prompt systematic treatment, about 6 to 12 months; first onset should be maintained for 2 to 3 years; second onset should be maintained for 5 years; those with 3 or more episodes or those whose symptoms never completely resolve with various treatments should be considered for lifelong Maintenance treatment.
–American Textbook of Comprehensive Psychiatry, Seventh Edition: 1 to 2 years for first episode; at least 5 years for multiple episodes; longer for those with suicidal, violent or aggressive behavior.
The purpose of drug maintenance treatment: to prevent relapse, improve the patient’s quality of life (including the treatment of negative symptoms), alleviate or reduce side effects.
4. Discontinuation: slow and gradual dose reduction until discontinuation.