How Schizophrenia Is Treated

If you have been diagnosed with schizophrenia, you might be wondering what to do next. The great news is that there are a variety of treatment options available. An important part of this journey is to explore your options and begin treatment quickly after diagnosis. This can help get your healing and management process going sooner than later, bringing you a sense of direction and relief.

schizophrenia treatment
Verywell / Cindy Chung 

Medications

Antipsychotic medications reduce the psychotic symptoms of schizophrenia and other mental illnesses, usually allowing a person to function more effectively and appropriately.

The first generation of antipsychotic medications, known as "typical antipsychotics," were introduced in the 1950s to treat psychosis. Antipsychotic drugs are the best treatment for schizophrenia right now, but they don't cure schizophrenia or ensure that there will be no further psychotic episodes.

Dosages

The choice and dosage of medication can be made only by a qualified physician who is well trained in the medical treatment of mental disorders. The dosage of medication is individualized for each patient, since people may vary a great deal in the amount of drug needed to reduce symptoms without producing troublesome side effects. It is important to be patient with yourself and your providers as you learn what works well for your personalized treatment.

Side Effects

Antipsychotic drugs can have unwanted effects along with their beneficial effects. Typical antipsychotics, which include drugs like Haldol and Thorazine, are known to increase the risk of extrapyramidal side effects, which affect movement and speech. Side effects of antipsychotic medications include:

  • Drowsiness
  • Restlessness
  • Muscle spasms
  • Tremor
  • Dry mouth
  • Blurred vision

Most of these symptoms can be corrected by lowering the dosage or controlled by other medications. Different patients have different treatment responses and side effects to various antipsychotic drugs. Talk with your doctor about your experiences at each visit so they can better understand your responses to medications and make adjustments to help.

Atypical Antipsychotics

A number of new antipsychotic drugs (the so-called "atypical antipsychotics") have been introduced since 1990. The first, clozapine (Clozaril), has been shown to be more effective than other antipsychotics, although the possibility of severe side effects requires that patients be monitored with blood tests every one or two weeks. After a year of stable white blood counts, blood can be drawn monthly.

The newer antipsychotic drugs are safer regarding tardive dyskinesia (TD) — an involuntary movement disorder — but many of the atypical drugs are more likely to contribute to metabolic side effects such as weight gain, increased glucose and lipids. Atypical antipsychotics include the following:

  • INVEGA (paliperidone): This option is available in three different formulations—an extended-release tablet and long-acting injectables (INVEGA SUSTENNA and INVEGA TRINZA)
  • Risperdal (risperidone)
  • Abilify (aripiprazole)
  • Seroquel (quetiapine)
  • Zyprexa (olanzapine)

Concerns About Medication

Patients and families sometimes become worried about the antipsychotic medications used to treat schizophrenia. In addition to concern about side effects, they may worry that such drugs could lead to addiction.

Antipsychotic medications do not produce a "high" and are not habit-forming, nor do they lead to addictive behavior in people who take them.

Another misconception about antipsychotic drugs is that they act as a kind of mind control or a "chemical straitjacket." Antipsychotic drugs used in the appropriate way do not "knock out" people or take away their free will.

Compliance

Making sure that you are taking your medications consistently can be referred to as medication compliance. As easy as it may sound to take medication regularly as scheduled, medication compliance is often one of the largest challenges of long-term treatment for schizophrenia.

Because of these challenges, new treatment options have become available that help make it easier for people to take their medications as prescribed. Long-acting injectables (LAI) are given to patients through and injection. These injections can be given every few weeks to few months, which help people experience more consistent, long-term, symptom relief.

Psychotherapy

Therapy is an important part of treatment for schizophrenia. Often you will find that mental health professionals work closely with psychiatrists to help make sure treatment methods are effective. For example, when someone's medication is working effectively, they are often better able to discuss and process during their therapy sessions.

Individual Therapy

One of the most researched models of therapy used in the treatment of schizophrenia is cognitive behavioral therapy, or CBT. This model of psychotherapy addresses the connection between thoughts and behaviors, helping people to learn more about how negative patterns of thought about themselves and the world influence their decision making.

Since insights like this are not often present in those with schizophrenia, cognitive behavioral therapy can help clients gain a greater sense of empowerment in regulating their emotions and behaviors. Speaking openly and honestly with your doctor is a great first step in understanding and ultimately managing your symptoms.

Schizophrenia Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

Mind Doc Guide

Family Therapy

Unfortunately, family members are often uninformed about what the condition is and how to help a loved one through the treatment process. Family therapy can be a key component of the treatment process, since it can offer space for healing of family dynamics that may have been impacted by the condition. That time can also be used for gathering information about schizophrenia, how to navigate challenges together and how to better express and meet needs of all involved.

Group Therapy

Support from peers can be a wonderful addition to the treatment process. Group therapy is space that allows people to safely share their experiences with schizophrenia, the challenges they are facing and what seems to be helping. Sharing information and feedback helps to remove a sense of isolation that can often be experienced. They can also create meaningful connections with peers, learning how to develop and maintain relationships along the way.

Social Skills Training

Because they experience psychotic features such as delusions and hallucinations, it can feel unclear to the person what is real and what isn't. That same uncertainty can be felt with interpersonal relationships as well, creating unhealthy dynamics between themselves and others. Learning the building blocks of relationships can help people better navigate interpersonal dynamics in their family lives, their social circles and possibly even in work settings.

Invasive Procedures

When existing treatment methods don't seem to be working effectively to help control symptoms, your doctor may suggest a procedure called deep brain stimulation. This is considered an invasive procedure because it involves surgery for the placement of neurostimulator. Electrical impulses are then able to be administered to certain parts of the brain through wired in that device that can help control symptoms without causing damage.

Complementary & Alternative Medicine

Animal Assisted Therapy

As with other conditions, animal assisted therapy (AAT) can help ease and manage some of the symptoms of schizophrenia. Anhedonia, which refers to not experiencing joy or pleasure, is a common symptom of schizophrenia. Research has found that, in trials using animal assisted therapy as part of treatment, patients rated higher levels of pleasurable feelings than those who did not participate in the animal assisted treatment group.

Dietary Supplements

Some nutritional supplements have been found to have a positive impact on symptoms experienced with schizophrenia. Although there are many factors continuing to be researched in this area, some of the vitamins and nutritional supplements that have been shown promising in the treatment protocol for schizophrenia have included things like:

  • Vitamin B
  • Omega-3 fatty acids
  • Amino acids
  • Melatonin
  • Antioxidants

It is important to note that, although the use of these supplements have shown promise in research, it is best to speak with your doctor before taking them to make sure you are not at risk for things like medication interactions or other things that could slow or stop your progress.

CBD Oil

Cannabidiol is an ingredient in the marijuana plant that has also shown promise in managing symptoms of schizophrenia. Some people may be worried that they will experience a "high" using CBD oil as you would smoking marijuana, but this is not true. The ingredient that would make you feel "high" and have that psychoactive component is called tetrahydrocannabinol or THC. THC is removed from CBD oil so you may experience relief from symptoms without worries about being in an altered state.

Where to Find Treatment

If you experience symptoms of schizophrenia it is best to speak with your doctor. They may want to do blood work and run tests to make sure the symptoms are not being caused by another medical condition. From there you can meet with a psychiatrist or other qualified mental health practitioner to discuss what you are experiencing.

Keep in mind that you may need to be evaluated extensively to make sure that the diagnosis is accurate. This evaluation process involves meeting with you to talk about your experiences, as well as meeting with a spouse or other family members to gather collateral information.

Levels of Care

Treatment can involve outpatient, intensive outpatient or residential treatment programs. The level of care that is best for your situation will be determined by the personal conducting your evaluation. There are trained professionals who specialize in the treatment of schizophrenia at each level of care. If you are unsure of where to find treatment providers, it is best to start by asking your doctor for local or regional referral options.

A Word From Verywell

It is important to be patient with yourself and your treatment team during this process. As much as we want the symptoms to subside, everyone has a different experience of what treatment methods work well for them and what doesn't seem to work well. Part of your treatment journey will be to explore and discover the methods that work best for you and your symptoms.

Being compliant with your treatment plan is important for overall success. This means doing things like:

  • Taking medication consistently
  • Attending your appointments regularly
  • Actively participating in counseling and group therapy
  • Letting your doctor know what you are experiencing
  • Asking your support group for help if needed
  • Being patient with yourself and your providers
  • Reminding yourself that this is a journey

Even if the path feels challenging, remember there are plenty of things you can do to help the process go more smoothly. The main thing is to be patient and talk with your doctor about your experiences. They need to understand your symptoms in order to help develop a treatment plan that works well for you.

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Article Sources

  1. Ramachandraiah CT, Subramaniam N, Tancer M. The story of antipsychotics: Past and present. Indian J Psychiatry. 2009;51(4):324-6. DOI:10.4103/0019-5545.58304

  2. Mathews M, Gratz S, Adetunji B, George V, Mathews M, Basil B. Antipsychotic-induced movement disorders: evaluation and treatment. Psychiatry (Edgmont). 2005;2(3):36-41.

  3. Asenjo lobos C, Komossa K, Rummel-kluge C, et al. Clozapine versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev. 2010;(11):CD006633. DOI:10.1002/14651858.CD006633.pub2

  4. U.S. Food & Drug Administration, "Are You Taking Medication as Prescribed?" June 9, 2009

  5. Brissos S, Veguilla MR, Taylor D, Balanzá-martinez V. The role of long-acting injectable antipsychotics in schizophrenia: a critical appraisal. Ther Adv Psychopharmacol. 2014;4(5):198-219. doi:10.1177/2045125314540297

  6. Gorwood P. Neurobiological mechanisms of anhedonia. Dialogues Clin Neurosci. 2008;10(3):291-9. PMID: 18979942

Additional Reading

  • National Institutes of Mental Health​. Antipsychotics. October 2016.

  • Taipale H, Mehtälä J, Tanskanen A, Tiihonen J. Comparative Effectiveness of Antipsychotic Drugs for Rehospitalization in Schizophrenia-A Nationwide Study With 20-Year Follow-up. Schizophr Bull. 2018 Oct 17;44(6):1381-1387. doi: 10.1093/schbul/sbx176.

  • Tiihonen J. Real‐world effectiveness of antipsychotics. Acta Psychiatr Scand. 2016 Nov; 134(5): 371–373.