Most People With Schizophrenia Struggle To Understand

Most People With Schizophrenia Struggle to Understand the Severity of Their Symptoms

Most people with schizophrenia struggle to understand the severity of their symptoms. Some of their ideas about their illness indicate that health professionals should provide more thorough education about their condition (Irawani & Asniar, 2022). Patients with schizophrenia of various ages. The nature of schizophrenia spectrum disorders with onset in middle or late adulthood remains controversial. Our study aimed to determine patients aged 60 and older (Smeets-Janssen et al., 2020).

Younger patients with schizophrenia have experienced fewer adverse effects of the illness than older patients. Antipsychotic use in the elderly is related to severe side effects (Targum et al., 2017). Careful consideration of comorbidity and polypharmacy is imperative (Behrman, Burgess & Topiwala, 2018). In this discussion, I will discuss schizophrenia in older adults and talk about one FDA-approved drug, one non-FDA-approved "off-label" medication, and one nonpharmacological treatment. The United States Food and Drug Administration has approved the administration of antipsychotic medications in treating schizophrenia in older adult populations.

In contrast to traditional antipsychotics, Seroquel is an atypical antipsychotic medication that is recommended. Atypical antipsychotics are available in various doses, but the recommended Seroquel dosage for elderly adults with schizophrenia should start from 50 mg at night, which helps also sleep. Seroquel doses will adjust depending on the patient's condition. An off-label drug such as lithium has been used in studies to help enhance mood and conduct in some patients but does not have an antipsychotic effect. It is used for the treatment of mania and depression. Lithium is the gold standard therapy for bipolar disorder (BD), but its effectiveness differs widely between individuals. It is also sometimes used to treat schizophrenia (Leucht, Helfer, Dold, Kissling, & McGrath, 2015).

The nonpharmacological intervention recommended for older adults with schizophrenia is psychosocial therapy. A long history of research has been conducted on psychosocial interventions aiming at enhancing independent functioning and social skills in schizophrenia. These therapies may be particularly beneficial in elderly patients since many fail to respond completely to antipsychotic medications (Cooper et al., 2020). Recent work has evaluated the benefits of a new, combined Cognitive Behavioral, Social Skills Training (CBSST) intervention in groups of older patients with primarily early-onset schizophrenia. Cognitive Behavior Therapy (CBT) combines the Social Skills Training (SST) elements of problem-solving and role-playing with the Cognitive Behavior Therapy (CBT) techniques of thought identification and challenging (Rajji, Mamo, Holden, Granholm, Mulsant, 2021).

The FDA-approved medicine for treating schizophrenia in older adults is Seroquel. The risks and benefits of Seroquel include the fact that it is an atypical antipsychotic medication that is recommended. Atypical antipsychotics are available in various doses, but the recommended Seroquel dosage for elderly adults with schizophrenia should start from 50 mg at night, which helps also sleep. Seroquel doses will adjust depending on the patient's condition. The main benefit of Seroquel is that it is an effective antipsychotic medication.

The main risks associated with Seroquel use include the fact that it can cause severe side effects, including extrapyramidal symptoms (EPS) and tardive dyskinesia. Lithium is the off-label drug used in studies to help enhance mood and conduct in some patients. The risks and benefits of lithium include the fact that it is the gold standard therapy for bipolar disorder (BD), but its effectiveness differs widely between individuals. Lithium is also sometimes used to treat schizophrenia (Leucht, Helfer, Dold, Kissling, & McGrath, 2015). The main benefit of lithium is that it is an effective mood enhancer.

The main risks associated with lithium use include severe side effects, such as gastrointestinal problems, tremors, and kidney issues. Clinical practice guidelines do exist for the treatment of schizophrenia in older adults. The main guideline that exists is the United States Food and Drug Administration's (FDA) guidance on the use of antipsychotic medications in treating schizophrenia in older adults. The FDA guidance recommends the use of atypical antipsychotic medications, such as Seroquel, in treating schizophrenia in older adults. The main reason for this recommendation is that atypical antipsychotics are less likely to cause severe side effects, such as extrapyramidal symptoms (EPS) and tardive dyskinesia.

Paper For Above instruction

Schizophrenia is a profound neuropsychiatric disorder characterized by a range of symptoms including hallucinations, delusions, disorganized thinking, and social withdrawal. It significantly impacts the quality of life, particularly in older adults, where age-related physiological changes can complicate diagnosis and management. Current treatment approaches emphasize both pharmacological and nonpharmacological therapies, tailored to the needs of the elderly population, with particular attention to the risks and benefits of medication use in this age group.

In elderly patients, managing schizophrenia presents unique challenges. The prevalence of comorbid medical conditions, polypharmacy, and increased sensitivity to side effects necessitate cautious use of antipsychotic medications. Evidence suggests that atypical antipsychotics are preferred due to their relatively favorable side effect profile compared to traditional, first-generation antipsychotics. Among these, Seroquel (quetiapine) has gained approval from the U.S. Food and Drug Administration (FDA) for use in older adults with schizophrenia. As an atypical antipsychotic, Seroquel offers effective symptom control with a reduced risk of extrapyramidal symptoms (EPS) and tardive dyskinesia, which are more common with typical antipsychotics (Maan et al., 2021).

Seroquel’s dosing in elderly patients typically begins at 50 mg taken at night, primarily to aid sleep, with careful dose adjustments based on individual response and tolerability (Remington et al., 2017). While effective, Seroquel’s use warrants vigilance due to potential severe side effects such as metabolic syndrome, sedation, orthostatic hypotension, and, rarely, myocarditis (Kane & Correll, 2022). Clinicians often weigh the benefits of symptom reduction against the risk of adverse events, emphasizing close monitoring and personalized treatment plans.

Beyond pharmacotherapy, nonpharmacological interventions are vital in managing schizophrenia in older adults. Psychosocial therapies, including cognitive-behavioral therapy (CBT) combined with social skills training (SST), have demonstrated substantial benefits. Such interventions target improving social functioning, reducing psychiatric symptoms, and enhancing independence (Cooper et al., 2020). Recent innovations have combined these techniques into integrated approaches like Cognitive Behavioral Social Skills Training (CBSST), which have shown promise in elderly populations, particularly those with early-onset schizophrenia experiencing age-related functional decline (Rajji et al., 2021).

Additionally, off-label use of medications such as lithium has been explored in some cases to manage mood disturbances associated with schizophrenia. Lithium’s primary indication is bipolar disorder, where it is considered the gold standard, but its effectiveness in schizophrenia remains less clearly defined. While lithium can offer mood stabilization and reduce certain symptoms, its use in elderly patients requires caution due to its narrow therapeutic window and potential side effects, including renal impairment, tremors, and gastrointestinal upset (Leucht et al., 2015). The decision to employ off-label medications like lithium must balance potential benefits against the risks, with close monitoring of serum levels and renal function.

In conclusion, treating schizophrenia in older adults demands a comprehensive, multidisciplinary approach. The FDA-approved use of atypical antipsychotics like Seroquel provides effective symptom management with a lower incidence of motor side effects, making it a preferred pharmacological option. Nonpharmacological interventions such as CBT and social skills training further support recovery and functional independence. Clinicians must consider individualized treatment plans, monitor potential adverse effects closely, and incorporate patient and caregiver education to optimize outcomes in this vulnerable population.

References

• Behrman, E. J., Burgess, L., & Topiwala, A. (2018). Pharmacotherapy considerations for the elderly with schizophrenia. Journal of Geriatric Psychiatry, 22(4), 210-222.
• Cooper, D., Green, M., Baird, A., et al. (2020). Psychosocial interventions for elderly with schizophrenia: A systematic review. Aging & Mental Health, 24(3), 341-351.
• Irawani, R., & Asniar, M. (2022). Patient education and awareness in schizophrenia management. International Journal of Psychiatry, 16(1), 45-52.
• Kane, J. M., & Correll, C. U. (2022). Pharmacologic treatment of schizophrenia. Dialogues in Clinical Neuroscience, 24(2), 115–128.
• Leucht, S., Helfer, B., Dold, M., Kissling, W., & McGrath, J. (2015). Lithium for schizophrenia? European Neuropsychopharmacology, 25(1), 11-20.
• Maan, J. S., Ershadi, M., Khan, I., & Saadabadi, A. (2021). Quetiapine. In StatPearls [Internet]. StatPearls Publishing.
• Remington, G., Addington, D., Honer, W., Ismail, Z., Raedler, T., & Teehan, M. (2017). Guidelines for the pharmacotherapy of schizophrenia in adults. The Canadian Journal of Psychiatry, 62(9), 629-640.
• Rajji, T., Mamo, M., Holden, J., Granholm, E., & Mulsant, B. (2021). Cognitive Behavioral Social Skills Training in elderly schizophrenia: A review. Journal of Clinical Psychiatry, 82(4), 20-27.
• Smeets-Janssen, M., Van de Mheen, D., & Van Mameren, J. (2020). Late-onset schizophrenia spectrum disorders: A review of cases. Psychiatry Research, 293, 113373.
• Targum, S. D., Greenberg, J. S., & Devanand, D. (2017). Antipsychotic use in older adults: Risks and benefits. American Journal of Geriatric Psychiatry, 25(6), 622-629.