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How is schizophrenia treated?

Manuj Nangia, MD
Psychiatry
In this video, Manuj Nangia, MD, at Good Samaritan Hospital, explains the causes and treatment of schizophrenia.
Schizophrenia is not curable but it is treatable. Treatment should involve the following:
 
  • Medication: Most individuals with schizophrenia must take medication regularly to control the illness. There will likely be a period of trial and error until the right medication is found with, hopefully, minimum side effects. It is important to choose a medication that is acceptable to the person in order to improve compliance and reduce relapse rates. Hopefully, therefore, the quality of life for this patient group can be enhanced.
  • Education: Families and other support groups should learn all they can about the disorder, including what assistance is available in their respective communities, such as day programs, self-help groups, and work and recreation programs.
  • Family counseling: Schizophrenia usually causes enormous emotional strain on the individual and family. Family counseling with a mental health professional knowledgeable about the disorder can be extremely helpful.
  • Hospitalization and regular follow-up: It is likely that an individual with acute schizophrenia will require hospitalization and regular follow-up upon release from the hospital. It is essential that the individual be observed, assessed, diagnosed, and started on medication under the close supervision of highly qualified staff.
  • Residential and rehabilitation programs: Social skills training combined with residential, recreational, and vocational opportunities especially designed for people with mental illness can result in improved outcomes for even the most severely ill individuals.
  • Self-help groups: There are family/peer and patient groups in many countries around the world that can be extremely important in helping the individual and family/peers through this illness. Others going through similar experiences can be vital resources for education and support.
  • Nutrition, rest and exercise: Recovery from schizophrenia requires patience. As with many recovery processes, it is important that the individual with schizophrenia has a well-balanced diet, adequate sleep, and regular exercise, even if the side effects of medication may make these goals challenging. Supervision of daily routines is often required.
  • Electroconvulsive therapy (ECT): This therapy is normally not used for individuals with schizophrenia unless they also suffer from extreme depression, are suicidal, and/or are non-responsive to other treatments.
Donna Hill Howes, RN
Family Medicine
Schizophrenia is treated with a combination of medications and psychosocial therapy. In some cases, electroconvulsive therapy may be used.

Medications used to treat schizophrenia may include typical (older or “conventional”) antipsychotics such as haloperidol, or atypical (newer) antipsychotics such as quetiapine. These are used to help improve the symptoms of schizophrenia. Benzodiazepines, such as lorazepam, and antidepressants or anti-anxiety medications, may also be helpful for people with schizophrenia. Some people may only be on antipsychotics, while others may be on a combination of different medicines to help them treat the different symptoms they experience.

Psychosocial therapy options are treatments that do not involve medicines. They may include family therapy, because the families of people with schizophrenia must learn how to deal with this difficult disease. Individual therapy may help people with schizophrenia cope with the distress that their symptoms often cause. It may also help in figuring out early signs of a relapse. Some people may benefit from vocational training, support groups, substance abuse counseling and rehabilitation, or a type of therapy called cognitive behavioral therapy.

In a certain type of schizophrenia, called catatonic schizophrenia, an important part of treatment is electroconvulsive therapy, sometimes called “shock therapy.” This treatment, which uses an electrical current to cause a seizure in the brain, can help improve the symptoms of catatonia or hyperactivity that people with catatonic schizophrenia often have.
Dr. Michael Roizen, MD
Internal Medicine

Schizophrenia is treated with antipsychotic medications and various types of psychotherapy. Since experts are still stumped on the exact causes of schizophrenia, medications and psychotherapy are aimed at relieving, and hopefully completely eliminating, symptoms. The most common medication used to treat schizophrenia is an antipsychotic medication. There are two types: typical and atypical. The typical ones were developed at the height of I Love Lucy’s popularity in the 1950s. Atypical antipsychotics were developed at the height of Friends and Seinfeld in the 1990s. Both reduce the positive and negative symptoms. Typical antipsychotics tend to treat the negative symptoms better, so it is not uncommon to be on multiple medications at once. Some drugs used to treat schizophrenia can cause some nasty side effects. Some have to be watched as closely as a toddler on a playground, and blood tests may be necessary so be sure to tell your doctor about anything unusual. And definitely do not stop taking the meds cold turkey.

There is no cure for schizophrenia. But two main types of treatment can help control symptoms: medication and psychosocial treatments.

Medication. Several types of antipsychotic medications can help, so the type of medication depends on the patient. Sometimes a person needs to try different medications to see which work best for him or her. Medications can also cause side effects. Most of the time side effects go away after a few days. Others take more time. Patients should always tell their doctor if her or she experiences the following side effects: blurry vision, uncontrollable body movements like shaking, dizziness, drowsiness, fast heartbeat, feeling restless, menstrual problems, sensitivity to the sun, skin rashes, and stiffness in the body.

Some types of antipsychotic medication can cause a lot of weight gain and other health concerns, which can lead to diabetes, high cholesterol, or other conditions. Other types of medication can also cause a movement disorder where a person cannot control muscle movements, especially around the mouth.

It is important to report any of these serious side effects to the doctor. Patients should not stop taking a medication without a doctor's help. Stopping medication suddenly can be dangerous, and it can make the symptoms of schizophrenia worse.

Psychosocial treatments. These treatments help patients deal with their illness from day to day. The treatments are helpful after patients find a medication that works. Treatments include:
  • Drug and alcohol treatment - this is often combined with other treatments for schizophrenia
  • Family education - ways to help the whole family learn how to cope with the illness and help their loved one Illness
  • Management skills - ways for the patient to learn about the illness and manage it from day to day
  • Rehabilitation - help with getting a job and everyday living skills
  • Self-help groups - support from other people with the illness and their families
  • Therapy - talking with a therapist about living with the illness and learning how to manage symptoms, like hearing voices or having delusions
This answer is based on source information from the National Institute of Mental Health.
Specific treatment for schizophrenia will be determined by your physician based on:
  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference
Schizophrenia is a major psychiatric illness. Treatment for schizophrenia is complex. A combination of therapies is often necessary to meet the individualized needs of the individual with schizophrenia. Treatment is aimed at reducing the symptoms associated with the disorder. Types of treatment that may be helpful to an individual with schizophrenia may include medications (also called psychopharmacological management; to reduce the symptoms of schizophrenia), including the following:
  • Neuroleptics – a specialized class of medications used to treat schizophrenia. Neuroleptics are used primarily to treat the pervasive, intrusive, and disturbing thoughts of a person with schizophrenia. They are designed to help minimize the severity of delusions and hallucinations the individual is experiencing.
  • Antipsychotic medications – medications that act against the symptoms of psychotic illness, but do not cure the illness. However, these medications can reduce symptoms or reduce the severity of symptoms; a specialized class of medications used to treat schizophrenia.
Other treatments include individual and family psychotherapy (including cognitive and behavioral therapy); specialized educational and/or structured activity programs (i.e., social skills training, vocational training, speech and language therapy); and self-help and support groups.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.