Schizophrenia, Schizoaffective and similar disorders are challenging for patients and their families. I provide careful initial evaluation, review of treatment options and continuing education for my patients and their families. My goal with to avoid hospitalizations and to maximize quality of life. I encourage work and other advances to levels of function.
Symptoms include a number of problems with quality of thought and perception. Some patients have unreasonable fears and delusions. Others deal with hallucinations of a variety of types, Many deal with both problems along with disorganization of thought and behavior. While much of the public fear patient with schizophrenia, these patients are much more likely to be assaulted than the general public. Unfortunately, self harm is commonly experienced.
Medication management of these conditions has changed a great deal over my career. We have a number of choices although frequently older medications are just as effective as newer and more expensive medications. Behavioral treatment is very important including exercise, avoidance of substance abuse, work and other activities.
Side effects can include metabolic problems such as weight gain, risk of diabetes, elevated cholesterol and other problems. I have been among the first to appreciate the need to monitor and intervene quickly for these problems. Exercise, diet and some other changes in treatment are frequently helpful.
I treat a number of patients with Clozapine and am an approved Clozapine Prescriber. This treatment requires compliance with medications and lab monitoring, but is currently the Gold Standard of treatment with a very good chance of long term benefit, ability to work and enjoy relationships. Long Acting Injectable medications often help prevent relapse by maintaining medication without having to take a pill daily.