schizophrenia_management_qa Flashcards
What is the first step in managing schizophrenia?
The management of schizophrenia is based on the biopsychosocial model, encompassing biological therapies, psychological therapies, and social interventions.
What is the role of the Early Intervention in Psychosis (EIP) Service?
The EIP Service aims to engage patients with very early symptoms of psychosis, providing antipsychotics and psychosocial interventions to keep the duration of untreated psychosis (DUP) under 3 months.
When should the crisis resolution team and home treatment team be used?
If urgent intervention is necessary, use the crisis resolution team and home treatment team.
What are the main classes of antipsychotics used in schizophrenia?
Antipsychotics are divided into typical and atypical classes. Typical antipsychotics include chlorpromazine and haloperidol, while atypical antipsychotics include olanzapine, risperidone, quetiapine, aripiprazole, clozapine, and amisulpride.
When should an atypical antipsychotic be considered?
An atypical antipsychotic should be considered when choosing first-line treatment in newly diagnosed schizophrenia, if there are unacceptable side effects from typical antipsychotics, or if relapse occurs on a typical antipsychotic.
What are the common side effects of antipsychotics?
Side effects include extrapyramidal symptoms (dystonia, akathisia, parkinsonism, tardive dyskinesia), hyperprolactinemia, sexual dysfunction, weight gain, sedation, increased risk of diabetes, dyslipidemia, anticholinergic effects, arrhythmias, and seizures.
What are the psychological treatments for schizophrenia?
Psychological treatments include CBT, family therapy, and concordance therapy. CBT helps with positive symptoms, family therapy reduces relapse rates, and concordance therapy encourages collaborative management.
What social interventions are included in schizophrenia management?
Social interventions may include admission to hospital, psychoeducation, addressing education, training, employment, housing, social activities, and developing personal skills.
What other treatments may be considered in schizophrenia management?
Other treatments include art therapy for negative symptoms, combined healthy eating and physical activity programs, smoking cessation support, and regular monitoring of weight and cardiovascular/metabolic parameters.
How is treatment resistance in schizophrenia managed?
First-line treatment for treatment-resistant schizophrenia is clozapine. Treatment resistance is defined as failure to respond to two or more antipsychotics given at therapeutic doses for at least 6 weeks.
What should be monitored before starting an antipsychotic?
Baseline measurements should include weight, waist circumference, pulse, blood pressure, fasting blood glucose, HbA1c, lipid profile, prolactin, assessment of movement disorders, nutritional status, diet, physical activity, and an ECG if necessary.
What is the summary of schizophrenia management?
First-line treatment is an atypical antipsychotic. CBT should be offered to all patients. Attention should be paid to cardiovascular risk factor modification due to high rates of cardiovascular disease in schizophrenic patients.
