Struggles in Managing Schizophrenia

Struggles in Schizophrenia Management

In the realm of mental health, schizophrenia stands as a complex condition that significantly impacts feelings, thoughts, behaviours, and perception of reality. Unfortunately, up to 83% of individuals who regularly take atypical antipsychotics report experiencing daytime sleepiness, and around 75% report difficulty sleeping. Moreover, about 52% report weight gain, with up to 86% of those with first-episode psychosis experiencing more than 7% of body weight gain in the first year of treatment.

These weight gain issues are concerning as obesity is prevalent in people with schizophrenia and is linked to significantly worsened mental and physical health. Factors contributing to weight gain include antipsychotic medication, sedentary lifestyle, largely consuming processed food, and genetics.

Antipsychotic medications can manage the positive symptoms (hallucinations and delusions) of schizophrenia, but they often come with unwanted side effects for many people. A review of studies from 2023 found that many people treated with atypical antipsychotics develop metabolic complications, including weight gain, insulin resistance, and abnormal cholesterol.

However, there are some antipsychotics that cause less weight gain. Ziprasidone, for instance, is known to cause the least weight gain among atypical antipsychotics. Additionally, medications such as olanzapine, clozapine, and quetiapine have been suggested to be more effective at reducing suicidal thoughts.

The negative symptoms of schizophrenia, which reduce or "take away" from someone's personality and don't respond to current antipsychotic medications, account for a large part of the disorder's long-term disability and functioning difficulty. Negative symptoms consist of five key areas: difficulty expressing emotions, reduction in the number of words spoken, reduced goal-directed activity due to decreased motivation, reduced social activity, and reduced experience of pleasure.

Treatment for these symptoms is still considered an urgent unmet need in psychiatry. Current research focuses on developing new strategies to reduce medication side effects, treat substance abuse, and address negative and cognitive symptoms. Promising approaches include the use of cannabidiol (CBD), which has shown potential to improve anxiety, sleep, and reduce antipsychotic drug doses, acting on cannabinoid receptors to support symptom management.

It's important to note that not taking prescribed medications is linked to an increased chance of psychosis relapse, persistent symptoms, and suicide attempts. Therefore, it's crucial for those living with schizophrenia to adhere to their treatment plans as closely as possible.

For more information on managing schizophrenia in everyday life, you can check out our schizophrenia hub. It's also worth mentioning that people with schizophrenia are more likely to have a substance use disorder compared to the general population. Substance misuse contributes to an increased risk of psychosis and suicide.

Researchers are working diligently to address these unmet needs, aiming to develop better antipsychotic medications with fewer side effects, more effective interventions for substance use disorder, and treatments for schizophrenia's negative and cognitive symptoms. These advancements hold promise for improving the lives of those affected by schizophrenia.