SCHIZOPHRENIA AND ITS HOMEOPATHIC MANAGEMENT

`                                                                  SCHIZOPHRENIA

DEFINITION:-

                Schizophrenia literally means “SPLIT” personality. It would be more appropriate to call it a split from reality. Actually the patient withdraws himself from reality and lives in a world of his own, full of false beliefs (delusions which cannot be corrected by reasoning or logic) and has false perceptions (hallucinations, sensory experiences mostly auditory which are non-existent) without any obvious stimulus.

AETIOLOGY OR CAUSES:-

                In western countries, schizophrenia is a common mental condition, atleast half of the beds in any mental hospital are occupied by schizophrenia. The aetiology remains unknown. There are a number of speculations as regards its causation.

-          GENETIC FACTORS:-

It is generally accepted that heredity does play a decisive role in its causation. The cold, introvert dreamy eccentric who is oversensitive or suspicious and is unable to deal with the odds of life is the man who is likely to be affected.

-          PSCHOLOGICAL STRESS AND ENVIRONMENT:-

As stated above, any psychological stress is likely to precipitate schizophrenia in a person, strained family or social relationship may similarly act as a precipitating factor.

-          BIOCHEMICAL FACTORS:-

There is possibly an over activity of the dopaminergic neurotransmitter substance in the mesolimbic and mesocortical areas. Drugs that stimulate dopamine receptors in the CNS (e.g. L-dopa and amphetamine) are likely to precipitate schizophrenia. Existence of an abnormal transmitter substance, possibly hallucinogenic in nature, has also been suspected.

-          CEREBRAL DAMAGE:-

Schizophrenia evidences of nonspecific type of atrophic changes in the brain (as deduced from enlargement of the ventricles) have been detected by CT scan. Schizophrenia like syndrome may be associated with such CNS disorders as cerebral tumor, demyelinating diseases, temporal lobe epilepsy and Huntington’s chorea. Role of an unknown virus has been suspected.

SYMPTOMS:-

                The following features are commonly present.

1.       A decreasing interest in the outside world.

2.       An increasing interest in himself – own thoughts, bodily symptoms and the past.

3.       Thinking in “own terms” (autistic thinking) – the thoughts are however, aimless, illogical and inconsistent. His thoughts are bizarre, irrational and jumbled up.

4.       Talking in “own terms”- he may talk and talk and talk on any topic whatsoever although his talk has no meaning or correlation with facts. He may write (and write enthusiastically with a sense of command on the subject) long letters or long essays on a wide variety of topics ranging from philosophy to sexology, often with no meaning.

5.       Showing flatness of emotions – he may quickly listen about the death of a near relative or a close friend and respond with a smile or shrugging of shoulders and does not seem to bother about it. On the contrary, he may start sobbing or crying or even turn violent on a trifle thing like loss of a pen or a match box.

6.       Exhibiting impulsive and inconsistent behavior and mannerisms.

7.       Living a life of fantasy full of hallucinations, delusions (usually of bizarre types) and false perceptions.

8.       Prominent feature of schizophrenia is recurrent remissions and relapses. During a period of remission, the patient behaves and lives like a normal man. A relapse is, however, bound to occur sooner or later.

TYPES:-

a.       SIMPLE TYPE:-

The patient lacks feeling for any emotion such as sadness or grief, joy or compassion, love or hate. he is dull, withdrawn, inactive and wishes to live alone.

b.      PARANOID TYPE:-

The patient has delusions (or false beliefs). He is egoistic, argumentative and aggressive due to delusion of grandeur – the feeling of being important.

c.       HEBEPHRENIC TYPE:-

Disorder of thought is the predominant symptoms. Thoughts are confused and the behavior is purposeless or silly. The speech is irrational and mannerisms are present. This type of schizophrenia is more common in males in the early thirties age. The patient gradually becomes depressed, dull and apathetic, losing all interest in the surroundings.

d.      CATATONIC TYPE:-

It is characterized by gross disorders of motor behavior (such as bizarre postures and activities of a madman) or terrific excitement alternating with periods of complete inactivity withdrawal or ever stupor. A peculiar type of muscular rigidity is often present. This is the commonest type of schizophrenia seen in India.

TREATMENT:-

1.       Antipsychotic drugs:-

-          Phenothiazine group of drugs are of great value and provide the first line of treatment.

-          Chlorpromazine (100-1500 mg daily) or thioridazine (50-500 mg daily) is used initially (either IM or orally).

-          Trifluperazine (5-30mg daily) may be tried in cases associated with hallucinations.

-          ECT may be helpful only in cases associated with depression.

2.       Psychotherapy and occupational therapy.

3.       Surgical treatment.

HOMEOPATHIC TREATMENT:-

1.       ANACARDIUM:-

Hallucinations; thinks he is possessed of two persons or wills. Syphilitic patients often suffer with these conditions. Anxiety when walking, as if pursued. Profound melancholy and hypochondriasis, with tendency to use violent language. Impaired memory. Absent mindedness. Malicious; seems bent on wickedness. Lack of confidence in himself or others. Suspicious [Hyos.]. Clairaudient, hears voices far away or of the dead.

2.       AURUM METALICUM:-

Feeling of self-condemnation and utter worthlessness. Profound despondency, with increased blood pressure, with thorough disgust of life, and thoughts of suicide. Great fear of death. Peevish and vehement at least contradiction. Anthropophobia. Mental derangements. Constant rapid questioning without waiting for reply. Cannot do things fast enough. Over sensitiveness; [Staph.] to noise, excitement, confusion.

3.       KALI BROMATUM:-

Profound, melancholic delusion; feeling of moral deficiency; religious depression; delusions of conspiracies against him. Imagines he is singled out as an object of divine wrath. Loss of memory. Must do something-move about; gets fidgety. [Tarant.]. Amnesic aphasia; can pronounce any word told, but cannot speak otherwise. Active delirium. Horrid illusions. Night terrors. General failure of mental power, loss of memory, melancholia, anaesthesia of the mucus membranes, especially of eyes, throat, and skin; acne; loss of sexual desire, paralysis.

4.       LACHESIS:-

Sad in the morning; no desire to mix with the world. Mental labor best performed at night. Great loquacity. Suspicious; nightly delusion of fire. Religious insanity. [Verat.; Stram.]. Derangement of the time sense. Restless and uneasy; does not wish to attend to business; wants to be off somewhere all the time. Jealous. [Hyos.].

5.       STRAMONIUM:-

Devout, earnest, beseeching and ceaseless talking. Loquacious, garrulous, laughing, singing, swearing, praying, rhyming. Sees ghosts, hears voices, talks with spirits. Rapid changes from joy to sadness. Delusions about his identity; thinks himself tall, double, a part missing. Cannot bear solitude or darkness; must have light and company. Sight of water or anything glittering brings on spasms. Delirium, with desire to escape. [Bell. Bry; Rhus.]. Religious mania.

6.       HYOSCYAMUS:-

It is as if some diabolical force took possession of the brain and prevented its functions. Very suspicious. Talkative, obscene, lascivious mania, uncovers body; jealous, foolish. Great hilarity; inclined to laugh at everything. Delirium, with attempt to run away. Low, muttering speech; constant carphologia, deep stupor.

7.       BELLADONNA:-

Patient lives in a world of his own, engrossed by specters and visions and oblivious to surrounding realities. While the retina is insensible to actual objects, a host of visual

Hallucinations throng about him and come to him from within. He is acutely alive and crazed by a flood of subjective visual impressions and fantastic illusions. Hallucinations; sees monsters, hideous faces. Delirium; frightful images; furious; rages, bites, strikes; desire to escape. Loss of consciousness. Perversity, with tears. Changeableness. Disinclined to talk.

8.       CHINA OFFICINALIS:-

Discontent; the patient deems himself unfortunate, and ill-used by the whole world. Great abundance of ideas, and of projects, with slow progress of thought (especially in the evening and at night). Fear of dogs and of other animals, especially at night. Excessive irascibility, with pusillanimity, and inability to bear the least noise. Disobedience. Hypochondriacal dejection. Apathy and moral insensibility.

9.       COCAINA:-

Talkative. Constant desire to do something great, to undertake vast feats of strength. Frightful persecutory hallucinations; sees and feels bugs and worms. Personal appearance neglected. Thinks he hears unpleasant remarks about himself. Hallucinations of hearing. Insomnia. Cerebral activity. Moral sense blunted.

Some of other drugs for schizophrenia are ignitia, nux vomica, rhus toxi, sulphur, zincum met, veratrum album, silicea, opium, lycopodium and helliborus.