Schizophrenia

Schizophrenia is a common mental illness associated with reduced life expectancy and a high attempted suicide rate.1,2,3

Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease.4 Therapeutic goals are to relieve symptoms, prevent relapse, promote recovery and improve quality of life.5 

An integrated treatment plan should include pharmacological, psychological and social interventions.5 Pharmacological treatment remains the mainstay of therapy, while psychosocial interventions are crucial in promoting recovery and improving quality of life.5

Pharmacological treatment usually includes antipsychotic medication, the choice of which will often be informed by:5

  • Access and availability
  • Shared patient-centered decision making
  • Previous experience (efficacy and side effects)
  • Tailoring the side-effect profile to the individual patient
  • Choice of mode of administration
     

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Half of all schizophrenia patient who stop taking their medication will relapse within 6–10 months, compared to one-fifth who will relapse on treatment.5 Long-term antipsychotic treatment reduces the risk of relapse over several years by two-thirds.5 

Continuation of pharmacological treatment that has been effective in the acute and stabilization phases is advised.5

Many South African mental illness patients do not receive adequate treatment.6 Research suggests that financial constraints can lead to >20% of patients stopping their medication.6

This highlights the need for high-quality, cost-effective antipsychotic medications for the treatment of schizophrenia and other mental illnesses.

References
1.

McCutcheon RA, Reis Marques T, Howes OD. Schizophrenia—An Overview. JAMA Psychiatry. 2020;77(2):201. doi:10.1001/jamapsychiatry.2019.3360

2.

Hjorthøj C, Stürup AE, McGrath JJ, et al. Years of Potential Life Lost and Life Expectancy in Schizophrenia: A Systematic Review and Meta-Analysis. The Lancet Psychiatry. 2017;4(4):295-301. doi:10.1016/S2215-0366(17)30078-0 

3.

Barak Y, Mirecki I, Knobler H, et al. Suicidality and Second Generation Antipsychotics in Schizophrenia Patients: A Case-controlled Retrospective Study During a 5-year Period. Psychopharmacology. 2004;175(2). doi:10.1007/s00213-004-1801-2

4.

U.S. Department of Health and Human Services. Schizophrenia. National Institute of Mental Health. 2009

5.

Emsley R, Flisher AJ, Grobler G, et al. The South African Society of Psychiatrists (SASOP) Treatment Guidlelines for Psychiatric Disorders. S Afr J Psych. 2013;19(3):2. doi:10.4102/sajpsychiatry.v19i3.942

6.

Trump L, Hugo C. The Barriers Preventing Effective Treatment of South African Patients with Mental Health Problems. Afr J Psych. 2006;9(4):249-260. doi:10.4314/ajpsy.v9i4.30224