Treatment
Any therapy for paranoid schizophrenia should be preceded by a precise diagnosis and assessment of the individual symptoms, since the therapy for schizophrenia has high individual differences and can therefore be adapted to the patient’s symptom spectrum. In principle, most patients can be treated on an outpatient basis and do not have to stay in the clinic for long periods of time. The latter is especially necessary in acute phases.
As a basic therapy for schizophrenia, structural offers such as sports, physiotherapy or music therapy should always be used. However, the core of schizophrenia treatment is in most cases the use of neuroleptics. Depending on the exact form of the disease, many different neuroleptics can be used.
The strongest effect of this therapy can be seen in the acute phase. In the long-term treatment of schizophrenia, psychotherapy plays an essential role in addition to drug treatment. This usually consists of behavioral therapy, which is supported by cognitive therapy and psychoeducation.
Psychoeducation is a relatively new therapy concept, which aims to enable patients to deal intensively with their illness and thus to understand it better. Thus, a very broad spectrum of therapeutic options is available in the treatment of paranoid schizophrenia in order to do justice to the individual patient and to be able to find an optimal therapy for the symptom spectrum. Drug therapy is one of the most important pillars in the treatment of schizophrenia.
The most obvious effect is achieved in the acute treatment of schizophrenic psychoses, whereas in long-term treatment other therapeutic strategies, such as psychotherapy, become more important. In principle, there are numerous medications that can be considered for the treatment of schizophrenia. These include antipsychotics or neuroleptics, but also benzodiazepines or antidepressants.
Antipsychotics today are divided into 2 large groups, which are characterized by different side effect profiles. The “typical” antipsychotics include mild to highly potent substances (Haloperidol, Melperon, …), which show very good claim rates in acute schizophrenic psychosis. What they have in common, however, is that they can lead to motor disorders that are very similar to Parkinson’s disease.
These side effects are summarized as so-called extrapyramidal motor disorder (EPMS). “Atypical” antipsychotics, on the other hand, lead to this severe side effect much less frequently, but are more often accompanied by weight gain or changes in heart activity. The most commonly used atypical antipsychotic is clozapine.
In addition to the antipsychotic effect, many drugs in this substance class also have a positive effect on any negative symptoms (loss of drive, flattening of the affect,..). How long a drug therapy should be taken depends largely on the previous course of the disease. If the first schizophrenic episode is only recommended to be taken for six to nine months, the period of use is extended to three to five years after the second episode.
