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Schizophrenia - Treatment

Alternative Names

Childhood-onset schizophrenia

Treatment:

During an episode of schizophrenia, you may need to stay in the hospital for safety reasons.

MEDICATIONS

Antipsychotic medications are the most effective treatment for schizophrenia. They change the balance of chemicals in the brain and can help control symptoms/

These medications are usually helpful, but they can cause side effects. Many of these side effects can be improved, and should not prevent people from seeking treatment for this serious condition.

Common side effects from antipsychotics may include:

  • Sleepiness (sedation)
  • Dizziness
  • Weight gain
  • Increased chance of diabetes and high cholesterol
  • Feelings of restlessness or "jitters"
  • Slowed movements
  • Tremor

Long-term use of antipsychotic medications may increase your risk for a movement disorder called tardive dyskinesia. This condition causes repeated movements that you cannot control, especially around the mouth. Call your doctor right away if you think you may have this condition.

When schizophrenia does not improve with several antipsychotics, the medication clozapine can be helpful. Clozapine is the most effective medication for reducing schizophrenia symptoms, but it also tends to cause more side effects than other antipsychotics.

Schizophrenia is a life-long illness. Most people with this condition need to stay on antipsychotic medication for life.

SUPPORT PROGRAMS AND THERAPIES

Supportive therapy may be helpful for many people with schizophrenia. Behavioral techniques, such as social skills training, can be used to improve social and work functioning. Job-training and relationship building classes are important.

Family members of a person with schizophrenia should be educated about the disease and offered support. Programs that emphasize outreach and community support services can help people who lack family and social support.

Family members and caregivers are often encouraged to help people with schizophrenia stick to their treatment.

It is important that the person with schizophrenia learns how to:

  • Take medications correctly and how to manage side effects
  • Notice the early signs of a relapse and what to do if symptoms return
  • Cope with symptoms that occur even while taking medication. A therapist can help.
  • Manage money
  • Use public transportation

Expectations (prognosis):

The outlook for a person with schizophrenia is difficult to predict. Most of the time, symptoms improve with medication. However, others may have difficulty functioning and are at risk for repeated episodes, especially during the early stages of the illness.

People with schizophrenia may need supported housing, job training, and other community support programs. People with the most severe forms of this disorder may not be able to live alone. Group homes or other long-term, structured places to live may be needed.

Symptoms will return if a person with schizophrenia does not take their medication.

Complications:

Having schizophrenia increases your risk for:

  • Developing a problem with alcohol or drugs: This is called a substance abuse problem. Using alcohol or other drugs increases the chances your symptoms will return.
  • Physical illness: People with schizophrenia may become physically sick, because of an inactive lifestyle and side effects from medication. A physical illness may not be detected because of poor access to medical care and difficulties talking to health care providers.
  • Suicide

Calling your health care provider:

Call your health care provider if:

  • Voices are telling you to hurt yourself or others.
  • You feel the urge to hurt yourself or others.
  • You are feeling hopeless or overwhelmed.
  • You are seeing things that aren't really there.
  • You feel you cannot leave the house.
  • You are unable to care for yourself.
  • Reviewed last on: 2/7/2010
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Leucht S, Corves C, Arbter D, Engel RR, Li C, Davis JM. Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet. 2009;373:31-41. Epub 2008 Dec 6.

Freudenreich O, Weiss AP, Goff DC. Psychosis and schizophrenia. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 28.

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