Lege Artis Medicinae

[Paths and mispaths - the current challanges of the treatment of schizophrenia: a cognitive perspective]


DECEMBER 15, 2015

Lege Artis Medicinae - 2015;25(11-12)

[Schizophrenia is a severe chronic mental disorder accompanied by acute psychotic episodes. The prognosis for and the quality of life of the patients is not primarily determined by the psychotic episodes that often require hospitalization, but rather by the disorder-specific cognitive deficits that persist and progress during the illness and precede the manifestation of the disorder. The greatest challenge in treating the disease is the treatment of the cognitive impairments, since our pharmacological therapeutic repertoire is mainly effective in controlling and preventing manifestation of the psychotic symptoms. The study provides a brief report on the anomalies of the current pharmacology- and hospital-centered care that are however a considerable obstacle to a modern neurocognitive developmental rehabilitation of people with schizophrenia with the aim of promoting social integration. This paper also summarizes the importance of the pharmacological treatments from the neurocognitive perspective, and finally presents the possibilities and results of the psychosocial rehabilitation in the treatment of the neurocognitive deficits in the hope of encouraging changing and a therapeutic paradigm shift. ]



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Lege Artis Medicinae


BÁNKI M. Csaba

[Schizophrenia is a severe and chronic disorder affecting almost 1% of the population worldwide. Antipsychotic drugs, currently in their secondgeneration (atypical) antipsychotics, represent its first-line treatment. Compliance during long-term maintenance pharmacotherapy is one of the key factors in successful patient management; longacting, injectable antipsychotics may significantly contribute to the improvement of the patients The new form of this drug is the first long-acting, injectable second-generation antipsychotic; administered biweekly it produces stable, reliable clinical efficacy. Low peak plasma concentrations and smaller plasma level fluctuations result in excellent tolerance, less side effects than with per os risperidone and minimal local pain due to its specific technology. There is strong evidence from controlled clinical trials for its prolonged efficacy during long-term administration and for patient satisfaction being usually better than with most other antipsychotics. Switching over to long-acting injectable risperidone often results in further improvement even in previously stable patients. No safety concerns have emerged from published evidence. The long-acting injectable risperidone appears to reduce the rehospitalisation rate, a major factor towards its cost-effectiveness.]