David Earl Johnson, LICSW

2 minute read

There is an important new research study on treatment of schizophrenia. They have found delayed or interrupted treatment is associated with permanent lost brain function and less success in recovery. That is indeed my clinical experience with schizophrenia and bipolar disorder. Any kind of chronic brain dysfunction makes permanent changes to brain structures and functioning. PTSD has been associated with permenent changes in emotion intensity and increased difficulty in emotion regulation. Chemical abuse has been associated with brain changes as well. When the brain is involved, respond quickly, ask for help and persist to be sure the treatment is effective. Anything less will cost you in brain function. This applies to any serious mental health or neurological problem. Psychiatric Weekly

In summary, it appears that there are benefits to be gained by identifying psychotic exacerbations early and bringing effective treatment to bear quickly (Table).11 If patients do not respond within the first 2 weeks to the initially prescribed antipsychotic, consider switching antipsychotics until you find something that works. When patients respond, our work is not finished. Optimize the response. Try to reduce psychopathology to a minimum. Attend to side effects; think of this task in terms of how you would feel if you had to take a medication every day for the rest of your life. Repeatedly inquire about patients’ judgments as to their need for medication and the value of the medications they are presently taking. Treat their viewpoints with respect, express your point of view on these issues with clarity and persistence, and make it clear that their feeling better is the goal for both of you.

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