Successful treatment of schizophrenia, therefore, depends upon a life-long regimen of both drug and psychosocial, support therapies. While the medication helps control the psychosis associated with schizophrenia (e.g., the delusions and hallucinations), it cannot help the person find a job, learn to be effective in social relationships, increase the individual’s coping skills, and help them learn to communicate and work well with others. Poverty, homelessness, and unemployment are often associated with this disorder, but they don’t have to be. If the individual finds appropriate treatment and sticks with it, a person with schizophrenia can lead a happy and successful life. But the initial recovery from the first symptoms of schizophrenia can be an extremely lonely experience. Individuals coping with the onset of schizophrenia for the first time in their lives require all the support that their families, friends, and communities can provide.

With such support, determination, and understanding, someone who has schizophrenia can learn to cope and live with it for their entire life. But stability with this disorder means complying with the treatment plan set up between the person and their therapist or doctor, and maintaining the balance provided for by the medication and therapy. A sudden stopping of treatment will most often lead to a relapse of the symptoms associated with schizophrenia and then a gradual recovery as treatment is reinstated.

Psychotherapy is not the treatment of choice for someone with schizophrenia. Used as an adjunct to a good medication plan, however, psychotherapy can help maintain the individual on their medication, learn needed social skills, and support the person’s weekly goals and activities in their community. This may include advice, reassurance, education, modeling, limit setting, and reality testing with the therapist. Encouragement in setting small goals and reaching them can often be helpful.

People with schizophrenia often have a difficult time performing ordinary life skills such as cooking and personal grooming as well as communicating with others in the family and at work. Therapy or rehabilitation therapy can help a person regain the confidence to take care of themselves and live a fuller life.

Group therapy, combined with drugs, produces somewhat better results than drug treatment alone, particularly with schizophrenic outpatients. Positive results are more likely to be obtained when group therapy focuses on real-life plans, problems, and relationships; on social and work roles and interaction; on cooperation with drug therapy and discussion of its side effects; or on some practical recreational or work activity. This supportive group therapy can be especially helpful in decreasing social isolation and increasing reality testing.

Family therapy can significantly decrease relapse rates for the schizophrenic family member. In high-stress families, schizophrenic patients given standard aftercare relapse 50-60% of the time in the first year out of hospital. Supportive family therapy can reduce this relapse rate to below 10 percent. This therapy encourages the family to convene a family meeting whenever an issue arises, in order to discuss and specify the exact nature of the problem, to list and consider alternative solutions, and to select and implement the consensual best solution.

Schizophrenia appears to be a combination of a thought disorder, mood disorder, and anxiety disorder. The medical management of schizophrenia often requires a combination of antipsychotic, antidepressant, and antianxiety medication. One of the biggest challenges of treatment is that many people don’t keep taking the medications prescribed for the disorder. After the first year of treatment, most people will discontinue their use of medications, especially ones where the side effects are difficult to tolerate.

As a recent National Institute of Mental Health Study indicated, regardless of the drug, three-quarters of all patients stop taking their medications. They stopped the schizophrenia medications either because they did not make them better or they had intolerable side effects. The discontinuation rates remained high when they were switched to a new drug, but patients stayed on clozapine about 11 months, compared with only three months for Seroquel, Risperdal or Zyprexa, which are far more heavily marketed — and dominate sales. Because of findings such as this, it’s generally recommended that someone with schizophrenia begin their treatment with a drug such as clozapine (clozapine is often significantly cheaper than other antipsychotic medications). Clozapine (also known as clozaril) has been shown to be more effective than many newer antipsychotics as well.

Antipsychotic medications help to normalize the biochemical imbalances that cause schizophrenia. They are also important in reducing the likelihood of relapse. There are two major types of antipsychotics, traditional and new antipsychotics.

Traditional antipsychotics effectively control the hallucinations, delusions, and confusion of schizophrenia. This type of antipsychotic drug, such as haloperidol, chlorpromazine, and fluphenazine, has been available since the mid-1950s. These drugs primarily block dopamine receptors and are effective in treating the “positive” symptoms of schizophrenia.

Side effects for antipsychotics may cause a patient to stop taking them. However, it is important to talk with your doctor before making any changes in medication since many side effects can be controlled. Be sure to weigh the risks against the potential benefits that antipsychotic drugs can provide.

Mild side effects: dry mouth, blurred vision, constipation, drowsiness and dizziness. These side affects usually disappear a few weeks after the person starts treatment.
More serious side effects: trouble with muscle control, muscle spasms or cramps in the head and neck, fidgeting or pacing, tremors and shuffling of the feet (much like those affecting people with Parkinson’s disease).

Side effects due to prolonged use of traditional antipsychotic medications: facial ticks, thrusting and rolling of the tongue, lip licking, panting and grimacing.
There are many newer antipsychotic medications available since the 1990’s, including Seroquel, Risperdal, Zyprexa and Clozaril. Some of these medications may work on both the serotonin and dopamine receptors, thereby treating both the “positive” and “negative” symptoms of schizophrenia. Other newer antipsychotics are referred to as atypical antipsychotics, because of how they affect the dopamine receptors in the brain. These newer medications may be more effective in treating a broader range of symptoms of schizophrenia, and some have fewer side effects than traditional antipsychotics.

Coping Guidelines For The Family
1. Establish a daily routine for the patient to follow.
2. Help the patient stay on the medication.
3. Keep the lines of communication open about problems or fears the patient may have.
4. Understand that caring for the patient can be emotionally and physically exhausting. Take time for yourself.
5. Keep your communications simple and brief when speaking with the patient.
6. Be patient and calm.
7. Ask for help if you need it; join a support group.

Self-help methods for the treatment of this disorder are often overlooked by the medical profession because very few professionals are involved in them. Adjunctive community support groups in concurrence with psychotherapy is usually beneficial to most people who suffer from schizophrenia. Caution should be utilized, however, if the person’s symptoms aren’t under control of a medication. People with this disorder often have a difficult time in social situations, therefore a support group should not be considered as an initial treatment option. As the person progresses in treatment, a support group may be a useful option to help the person make the transition back into daily social life.

Another use of self-help is for the family members of someone who lives with schizophrenia. The stress and hardships causes of having a loved one with this disorder are often overwhelming and difficult to cope with for a family. Family members should use a support group within their community to share common experiences and learn about ways to best deal with their frustrations, feelings of helplessness, and anger.

Hot flashes last for a minimum of 2-3 years. Clonidine is the drug prescribed throughout the world to give some relief form hot flashes. It will also lower your blood pressure. Unfortunately the patient tends to become addictive. Hence, it can only be prescribed for a very short period of time. Still a lot of research is being conducted to find a better alternative.

Estrogen therapy is also a well known therapy for hot flashes. It increases the bone mass and will keep you away form fractures and cholesterol. The uncomfortable vaginal symptoms are also controlled to a great extent. Basically it makes for the lack of estrogen in the body of a women undergoing menopause. This will save her from colon cancer. On the contrary any therapy that involves both progesterone and estrogen treatment will increase the heat disease threat. A close study of the woman’s past medical history should be conducted in order to start this therapy. One can opt for different ways to take estrogen in her system. There are vaginal suppositories and creams. Even oral tablets add to ones estrogen level.

In case of woman who still haven’t got their uterus removed should not undergo hysterectomy. They should instead opt for a combination of hormone progesterone and estrogen. This is because when only estrogen is taken, the risk of uterine cancer increases. Progesterone will reduce the risk to a great extent. In fact this combination is also called hormone therapy. Unfortunately this therapy increases risk of breast cancer. Hormone therapy for more than 5 years makes ones body prone to breast cancer.

Whatever the menopause medication may be, don’t forget investigate its pros and cons. These medicines are supposed to make you healthy. The side effects should not trap you in future illness.
And most importantly before trying any type of medication yourself, make sure that you consult with your doctor. It is only they who are trained and in a better position to guide you.

The use of medication is just one of the many treatment options available to manage the symptoms of anxiety disorders. Parents are understandably hesitant about putting their children on medications without knowing which ones are appropriate, how they will affect their child, and if and when they are safe to use.
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If you got children and facing anxiety disorder, what would you do? below are 12 frequently asked questions about treating anxiety disorders in children with medication:
1. Which medications are typically used to treat anxiety disorders in children?
2. Are SSRIs safe for my child?
3. How is the clinical need for medication determined?
4. What are the most common side effects of SSRIs?
5. What do I do if my child develops side effects?
6. How can I tell if the medication is working?
7. How long will it take for the medication to work?
8. How long will my child need to take medicine?
9. Will my child become addicted to these medications? Will the medications change my child’s personality?
10. What if my child refuses to take the medication?
11. Can SSRIs be used with other medications, including over-the-counter medicines for common illnesses such as a cold or the flu?
12. Are there other treatments available if I don’t want to put my child on medication?

And below are the answers:
1. Which medications are typically used to treat anxiety disorders in children?

The selective serotonin reuptake inhibitors (SSRIs) are currently the medications of choice for the treatment of both childhood and adult anxiety disorders. This group of medications includes fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro). Tricyclic antidepressants (e.g. imipramine) and benzodiazepines (e.g. lorazepam) are less commonly used in the treatment of childhood anxiety disorders. Other medications have been used to treat anxiety disorders in adults but require further study in children and adolescents.

The Food and Drug Administration (FDA) has approved the use of fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), and clomipramine (Anafranil) for the treatment of pediatric Obsessive-Compulsive Disorder. SSRIs are commonly used in clinical practice to treat youth with other anxiety disorders as well based upon controlled studies that report improvement in symptoms and medication safety in children and adults with anxiety and depressive disorders. Controlled clinical studies provide the necessary information for the FDA to determine whether medications will be approved. Unfortunately, studies of the use of medications in children lag behind studies of adults; more research is definitely needed in this area. Discuss the risks and benefits of all medications prescribed for your child, whether FDA approved or not, with your physician.

2. Are SSRIs safe for my child?

The Food and Drug Administration issued a warning in October 2004 that antidepressant medications, including SSRIs, may increase suicidal ideation and suicidal behaviors in a small number of children and adolescents. The FDA report was based upon review of 24 different short-term (4 to 16 weeks) studies of 9 antidepressant medications (SSRIs and others) involving over 4,400 children and adolescents with major depressive disorder, obsessive-compulsive disorder, or other psychiatric disorders. Analyses of the studies showed that the average risk of suicidal ideation and suicidal behaviors occurred in 4% of patients treated with an antidepressant, compared to 2% of patients who were treated with a placebo (sugar pill). No suicides occurred in any of the studies.

Caregivers should be open to asking their child or adolescent if he/she is having suicidal thoughts, and to monitor for changes in behavior such as agitation, restlessness, irritability or other changes in your child’s behavior or personality. Parents should contact their child’s doctor if any of these or other concerns arise. The medication dose may need to be lowered, or the medication may need to be discontinued. Patients should not stop taking their medication abruptly without their doctor’s supervision since this may worsen symptoms. In the recent review of studies by the FDA, there was some limited evidence that suicidal ideation and behaviors occurred most often at the beginning of treatment or at the time of a dosage change. However, because this evidence was far from definitive, monitoring should occur throughout treatment.

The FDA warning does not prohibit the use of these medications in children and adolescents. The FDA warning alerts patients and families to the risk of suicidal thoughts and behavior, but also notes that this risk must be balanced with clinical need.

3. How is the clinical need for medication determined?

Medications are used to treat anxiety disorders when symptoms are causing significant subjective distress for the child and/or are contributing to persistent functional impairment e.g. difficulties at school, with peers, and/or at home. Severity of symptoms will determine whether medications are started at the beginning of treatment at the same time as psychotherapy, or added later if symptoms do not improve with psychotherapy alone.

Some clinicians have argued that medications should only be used after children with an anxiety disorder fail to respond to psychotherapy. While this is a reasonable position, opinions remain mixed on this view. For example, many children with severe anxiety will not even begin to initiate the tasks that must be completed for psychotherapy to be successful. Others will simply refuse to talk with a therapist at all. For these children, it would be reasonable to initiate treatment with a medication before a course of psychotherapy has been attempted.

Caregivers should be open to asking their child or adolescent if he/she is having suicidal thoughts, and to monitor for changes in behavior such as agitation, restlessness, irritability or other changes in your child’s behavior or personality. Parents should contact their child’s doctor if any of these or other concerns arise. The medication dose may need to be lowered, or the medication may need to be discontinued. Patients should not stop taking their medication abruptly without their doctor’s supervision since this may worsen symptoms. In the recent review of studies by the FDA, there was some limited evidence that suicidal ideation and behaviors occurred most often at the beginning of treatment or at the time of a dosage change. However, because this evidence was far from definitive, monitoring should occur throughout treatment.

to be continued in next article