Schizophrenia and Medication - Part Three

  • A new study that examined more than 50 years worth of data found antipsychotic medications for schizophrenia patients can reduce the risk of relapse by 60 percent.


    The study revealed that these patients who are compliant with their medication are significantly less likely to be hospitalized and may have a better quality of life than individuals who do not take their medication.


    The trials in the studies, observed from 1959 and 2011, showed a 64 percent relapse rate with those who took a placebo, in relation to a 27 percent relapse rate among compliant patients.


    Three of the studies demonstrated the schizophrenia patients, who took their meds, had a better quality of life.  [Health Day (2012, May) Medication compliance helps schizophrenia patients. accessed May 10, 2012.]

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    How can we remember to take our pills?


    A guy who takes two kinds of pills turns his pill bottles upside down after he's taken his dose.  I keep mine in one 7-day pill box for morning and one 7-day pill box for night.  Before I go to bed, I lift the lids of the next day's compartments to signal I have to take them.  If I dine out, I carry the pills in one of seven attractive pill boxes, like art objects, I've collected over the years.


    You can get DoseCast, an iPhone app, that schedules your doses.  Bring your pills in their bottles or pill boxes in your carry-on when you travel because luggage can get lost.


    Figure out the best dose times.  I have no side effects now ever since I began taking most of the Geodon at night, so I'm wide awake every day instead of falling asleep routinely.


    You shouldn't have to settle for less than the best possible outcome.  My doctor told me years ago that total symptom relief was the only acceptable goal.


    Some things to keep in mind:

    • It is generally agreed that patients do not build up a tolerance to their antipsychotic meds.
    • When it appears that the meds are not working as well as they previously have, it is often the result of the disease itself changing.
    • When consumers stop taking their medicine they run the risk of not being able to regain the previous level of wellness.
    • Currently it is in the very early stage of research but many clinicians believe the glutamate system has promise.


    [Medland, M. (2012, Spring) Medication tolerance: Can antipsychotics lose their effectiveness over time? 10(2), 16-17.]


    In April 2007, I switched to the atypical because the former drug stopped working, or so it seemed.  I recommend you talk to your doctor at the first sign of any new or unusual thoughts or symptoms that seem to have become repetitive.


    A common scenario is that a person might exhibit residual or breakthrough symptoms.


    Talk with your doctor about changing the dose, or changing the medication, if necessary.


    I know one guy who paraded through various doctors' offices until he found a psychiatrist who was an expert on medication, and she prescribed the new drug that immediately stopped his voices after he'd been hearing them for quite awhile.


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    It's not always possible to put your treatment on autopilot and take the same drug and do the same things for 50 years.  I'm lucky I had the chance to take the newer atypical because it was like a miracle drug.  I even wrote a poem about the drug.


    You can write your questions down on an index card and take it to your visit to ask the doctor the questions.  Bring blank index cards to write down the answers on.


    You need to feel you can trust your doctor completely, so you might have to search around for one.  You can also see your regular doctor and then go to a psychiatric specialist for a review of your treatment every so often, as one guy does.


    If at all your intuition tells you to question what a doctor recommends, speak up.  Ask about the side effects, because psychiatrists are famous for prescribing pills and not telling you the side effects.  Luckily, I gained no weight from the Geodon.


    You also need to find out how long it will reasonably take to achieve the full response from the medication, after which point no improvement is likely.  This will help you gauge when to consider switching medication, or to stick with the one you're on.


    Your session might be limited to 15 or 20 minutes, so it's absolutely your right to set specific treatment goals.  Read my SharePosts on Setting Treatment Goals and Measuring Recovery Gains.


    I admit, I see my doctor every two months now, so I write down on index cards everything I want to discuss.  I'm lucky I'm able to memorize the key points so I make sure we address them in each session.  Yes, I do have an agenda for nearly every visit.  It's rare I don't plan in advance what I want to talk about.


    Your pharmacist can be your own health guide when your doctor might not know the answers.  Actually, the woman I talk to at my pharmacy is a technician.  (I found this out recently.)  She's worked there so long she knows nearly everything about the drugs, so I can rely on her advice and dispense with seeing the pharmacist.


    The road to optimal mental health could feel like an endless highway sometimes.


    Recovery is a journey, not a destination.  You can be recovered (it is possible) yet it still takes vigilant dedication to your recovery and consistent monitoring of your symptoms to stay well.


    Coming up in June:


    I'll detail the breaking news in the field, plus begin writing about topics like schizophrenia and smoking and other lifestyle concerns.


Published On: May 27, 2012