Schizophrenia treatments: oral medication vs. long-acting injectables?

Living with schizophrenia can be daunting for the person diagnosed with the disorder and for their loved ones. But help is available.

This chronic mental illness,[1] presents itself in people from their late teens to early adulthood when they start showing symptoms.[2]

Some of the symptoms associated with schizophrenia include,[2]

  • Hallucinations
  • Disorganised thinking
  • Distorted speech
  • Hearing voices, and
  • Disinterest in everyday activities.

The stigma around schizophrenia is often associated with the belief that those living with this mental disorder are prone to violence. A British study concluded that more than 70% of people assume those diagnosed with schizophrenia are dangerous.[3] This negative perception also affects people living with schizophrenia, who delay seeking the right treatment for their diagnosis.[3]

Treatments for schizophrenia

Although there is no cure for schizophrenia, treatment is available. Doctors can recommend a course of treatment based on the severity of the schizophrenia diagnosis, which they determine after an examination. This examination includes a psychological and medical evaluation. Doctors will also enquire if the person exhibiting the symptoms of schizophrenia has been admitted to hospital previously for a mental condition.4

To make sure the diagnosis is accurate, doctors will plan urine or blood tests to ensure the symptoms aren't being caused by alcohol or drug abuse. After ruling out other medical conditions, they'll use MRI or CAT scans.4

With early diagnosis, and taking the right course of treatment, people living with schizophrenia can enjoy a fulfilling life.

The treatment is called antipsychotic medication and addresses two of the symptoms most associated with schizophrenia - delusions and hallucinations.[1]

Treatment for schizophrenia is available in two forms, namely oral medication and long-acting injectables.[1] Doctors can decide what the best treatment options are, and this is based on several factors including how well the symptoms react to the treatment, and how often the medication should be administered.[1]

Oral medication

Once diagnosed by a doctor, a person living with schizophrenia can be prescribed oral medication, available in tablet or liquid form.[1] This type of treatment should be administered daily.[1]

Most oral treatments for schizophrenia are called first-generation antipsychotics. They were first developed in the 1950s,5 and there's subsequently been significant advancements in technology and medicine.

For some people, taking oral medication becomes too much of a commitment, and they may stop taking their medication causing them to relapse.6 Some people feel they're getting better, and stop their daily treatment entirely,6 while other people simply forget to take their medication.6

This is one of the main reasons why long-acting injectables were developed.7

Long-acting injectables

Long-acting injectables can be taken once or twice a month and are administered by a doctor.[1] Some long-acting injectables are even designed to only be administered once every three months,6 making it more convenient for people living with schizophrenia to stay on their treatment course.

According to studies, only about 40% to 60% of people diagnosed with schizophrenia continue to take their daily medication,6 and this is why long-acting injectables are important.

Long-acting injectables can only be administered by a healthcare professional, making it easier for doctors to know if a person with schizophrenia is still on course with their treatment.6

It's advised that when long-acting injectables are administered, the person remains under the watchful eye of the healthcare professional for a few hours of observation.6 This is to observe any side effects like confusion or dizziness, which less than 1% of people experience after long-acting injectables are administered.6

If you or a loved one are experiencing symptoms of schizophrenia, visit a doctor for an examination. Find out more about the symptoms and diagnosis of schizophrenia here.

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References

National Institute for Clinical Excellence. Psychosis and schizophrenia in adults: prevention and management. 2014. CG178.
APA Clinical Guidelines. American Psychiatric Association. Practice Guidelines for the treatment of patients with schizophrenia. 2004.
Hasan et al. World J Biol Psychiatry 2012; 13: 318─378.
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