In Bangladesh where the treatment of any and all mental health is mainly by the use of drugs instead of significant cognitive behavioural therapy, these are the drugs which are mostly used.
Antipsychotics are usually recommended as the initial treatment for the symptoms of an acute schizophrenic episode. Antipsychotics work by blocking the effect of the chemical dopamine on the brain.
Antipsychotics can usually reduce feelings of anxiety or aggression within a few hours of use, but may take several days or weeks to reduce other symptoms, such as hallucinations or delusional thoughts.
Antipsychotics can be taken orally (as a pill) or given as an injection (known as a ‘depot’). Several ‘slow release’ antipsychotics are available. These require you to have one injection every two to four weeks.
You may only need antipsychotics until your acute schizophrenic episode has passed. However, most people take medication for one or two years after their first psychotic episode to prevent further acute schizophrenic episodes occurring and for longer if the illness is recurrent.
There are two main types of antipsychotics:
Typical antipsychotics are the first generation of antipsychotics developed during the 1950s.
Atypical antipsychotics are a newer generation of antipsychotics developed during the 1990s.
Atypical antipsychotics are usually recommended as a first choice because of the sorts of side effects associated with their use. However, they are not suitable or effective for everyone.
Both typical and atypical antipsychotics can cause side effects, although not everyone will experience them and their severity will differ from person to person.
The side effects of typical antipsychotics include:
Side effects of both typical and atypical antipsychotics include:
weight gain, particularly with some atypical antipsychotics
lack of sex drive
Tell your psychiatrist if your side effects become severe. There may be an alternative antipsychotic you can take or additional medicines which will help you deal with the side effects.
Do not stop taking your antipsychotics without first consulting your psychologist, psychiatrist or doctor. If you do, you could have a relapse of symptoms.
Psychological treatment can help people with schizophrenia cope better with the symptoms of hallucinations or delusions.
They can also help treat some of the negative symptoms of schizophrenia, such as apathy or a lack of enjoyment.
Common psychological treatments include:
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT), although not practiced much in Bangladesh, aims to help you identify the thinking patterns that are causing you to have unwanted feelings and behaviour, and learn to replace this thinking with more realistic and useful thoughts.
Many people with schizophrenia rely on family members for their care and support. While most family members are happy to help, caring for somebody with schizophrenia can place a strain on any family.
Family therapy is a way of helping you and your family cope better with your condition.
Family therapy involves a series of informal meetings over a period of around six months. Meetings may include:
discussing information about schizophrenia
exploring ways of supporting somebody with schizophrenia
deciding how to solve practical problems that can be caused by the symptoms of schizophrenia
If you think you and your family could benefit from family therapy, speak to your psychologist, psychiatrist or doctor.