 Hara Oyedeji, PMHNP-BC, APRN, MSN, MSEd 

Panelists discuss how current standard treatments primarily address positive symptoms through D2 receptor blockade medications and cognitive behavioral therapy but often provide only partial efficacy while potentially worsening negative and cognitive symptoms that most impact daily functioning.

Standard of Care Treatments in Schizophrenia

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Current schizophrenia treatment protocols primarily rely on dopamine D2 receptor blockade medications combined with cognitive behavioral therapy, but these approaches show significant limitations in addressing the full spectrum of symptoms. While traditional antipsychotic medications demonstrate effectiveness in managing positive symptoms like hallucinations and delusions, they often provide only partial efficacy and may actually worsen negative symptoms and cognitive impairments that most severely impact patient functioning and quality of life.

The standard of care creates a challenging risk-benefit balance for clinicians and patients. Medication side effects include metabolic issues, weight gain, cognitive blunting, and emotional numbing that patients describe as feeling like "zombies." These adverse effects frequently lead to medication non-adherence, creating a cycle where patients discontinue treatment due to side effects, experience symptom relapse, and require hospitalization. The limitations become particularly problematic when patients cannot engage in psychotherapy due to cognitive impairments or lack of insight into their condition.

Healthcare providers must navigate these treatment challenges while recognizing that schizophrenia is a neurodegenerative condition requiring lifelong management rather than cure. The goal shifts from complete symptom elimination to functional improvement and preventing further brain deterioration. This reality necessitates exploring emerging treatment modalities that can address unmet needs in negative symptom management and cognitive enhancement while minimizing debilitating side effects.

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Panelists discuss how schizophrenia affects 3.5 million Americans through three distinct symptom domains - positive symptoms (hallucinations), negative symptoms (social isolation, reduced functioning), and cognitive symptoms - rather than just the commonly perceived "hearing voices.”

Schizophrenia Symptoms

Gus Alva, MD and nurse practitioner Hara Oyedeji, PMHNP-BC, APRN, MSN, MSEd explore the multifaceted nature of schizophrenia, a condition affecting 3.5 million Americans and 24 million people worldwide. Unlike common misconceptions that reduce schizophrenia to simply "hearing voices," this neuropsychiatric disorder encompasses three distinct symptom domains: positive symptoms (hallucinations and delusions), negative symptoms (social withdrawal and reduced emotional expression), and cognitive impairments that significantly impact daily functioning.

The presentation emphasizes how negative symptoms and cognitive deficits often prove more debilitating than the hallucinations typically portrayed in media. These symptoms include social isolation, depression, anxiety, and difficulties with memory and executive functioning that prevent patients from maintaining employment, relationships, and independent living. The cognitive component particularly affects activities of daily living, making it challenging for individuals to navigate basic tasks like managing finances, maintaining hygiene, or using public transportation.

Healthcare providers must recognize that schizophrenia treatment extends far beyond addressing auditory hallucinations. The comprehensive symptom profile requires integrated approaches that target all three domains simultaneously. Understanding this complexity is crucial for developing effective treatment strategies and setting realistic expectations for both patients and families navigating this chronic, lifelong neuropsychiatric condition.

Hara Oyedeji, PMHNP-BC, APRN, MSN, MSEd

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