Schizophrenia

What is schizophrenia?

Schizophrenia is a chronic, disabling mental illness that involves abnormal thinking, a loss of contact with reality, hallucinations (seeing or hearing things that are not really there) and delusions (beliefs a person has that are actually untrue or false). No one knows for sure what causes schizophrenia. It may be caused by both genetic and environmental factors. Abnormal levels of some brain chemicals may also play a part. These chemicals are called neurotransmitters. Neurotransmitters influence our thought processes and emotions.

How do people who have schizophrenia think and act?

People who have schizophrenia may seem different from other people. They may seem to show fewer emotions than others. They may keep to themselves and withdraw from social contact. At times they may seem slowed down, as if they don't have enough energy. They may not bathe regularly or maintain their hygiene. They may lose interest in hobbies and everyday activities.

People who have schizophrenia may have unusual untrue beliefs, called delusions. For example, they may believe that others are spying on them or that they are famous people from history. Sometimes, they may hear voices telling them what to do or saying things about them. Voices that other people can't hear and visions that other people can't see are called hallucinations. A schizophrenic person's thoughts may also race through his or her mind, becoming confused and disorganized. His or her speech may also be disorganized. These symptoms come and go, often occurring after stressful events.

How is schizophrenia treated?

In the past, schizophrenia has been treated with medicines that block the action of a brain chemical called dopamine. These medicines help control the abnormal thinking, hallucinations, delusions and disorganized thinking of people who have schizophrenia. Unfortunately, the medicines also have side effects that can include a decrease in a person's ability to show emotion, muscle stiffness, weight gain and tremors. The medicines can cause other unpleasant side effects, such as unusual movements of the tongue, face, arms and legs (called tardive dyskinesia). Rarely, people who use these medicines can also develop a dangerous syndrome called neuroleptic malignant syndrome (NMS). NMS causes extremely rigid muscles, very high body temperature, high blood pressure and confusion. In severe cases, NMS can cause coma.

Newer medicines are now also available to treat people who have schizophrenia. These drugs block the brain chemical called serotonin in addition to blocking dopamine. They help control the abnormal thinking, hallucinations, delusions and disorganized thinking associated with schizophrenia. They also improve the social withdrawal and lack of emotion that occurs in people who have the disease.

Do the newer drugs have any side effects?

Like all medicines, the newer medicines for treating schizophrenia can cause side effects. Not everyone experiences these side effects. The side effects you may develop depend on which medicine your doctor chooses for you.

While you're taking a medicine to treat schizophrenia, you may need to see your doctor on a regular basis for certain tests. For example, a medicine called clozapine (brand name: Clozaril) can lower the number of white blood cells in your body. This makes it easier for you to get an infection. People taking clozapine must have their blood checked every week. Your doctor will tell you if you need to see him or her for tests.

What else should I know about medicines for schizophrenia?

  • Take the medicine at the same time everyday.
  • Drink plenty of liquids.
  • You may be sensitive to temperature, so avoid spending too much time in the sun and wear warm clothing during cold weather.
  • Do not stop taking your medicine without first talking to your doctor.
  • If you notice that your problems with thinking and other symptoms are getting worse, or if you develop any unusual symptoms or fevers, you should talk to your doctor.

Are there other forms of treatment for schizophrenia?

Medicine is the main form of treatment for schizophrenia, but there are other treatments that can help people who have this disease. Patients may benefit from psychotherapy, where they will learn how to cope with the effects of schizophrenia. Rehabilitation can also help people redevelop their social skills and receive coaching on how to live independently. These skills can help a person who has schizophrenia to work, care for him or herself, live on his or her own and maintain relationships with others.

What is in the future for people who have schizophrenia?

The less time people who have schizophrenia experience hallucinations or delusions, the better they do in the long run. Taking the right medicine regularly will prevent outbreaks of abnormal thinking and limit the consequences of having schizophrenia.

Researchers are learning more and more about how the brain works. With this information, better medicines with fewer side effects can be developed so that people who have schizophrenia can live without being limited by their illness.

More Information

For more information talk to your doctor.

Source

Written by familydoctor.org editorial staff.

American Academy of Family Physicians

Reviewed/Updated: 10/08
Created: 09/00