There is no cure for Schizophrenia. But two main
types of treatment can help control symptoms:
medication and psychosocial treatments.
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 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
about these problems.
Side effects include:
Body movements a person can't control, like
Sensitivity to the sun
Stiffness in the body.
Some types of antipsychotics can cause a lot of
weight gain and other health concerns, which can
lead to diabetes, high cholesterol, or other
conditions. Still other types can 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 Schizophreniaworse.
Because the causes of Schizophreniaare still
unknown, treatments focus on eliminating the
symptoms of the disease. Treatments include
antipsychotic medications and various psychosocial
Antipsychotic medications have been available since
the mid-1950's. The older types are called
conventional or "typical" antipsychotics. Some of
the more commonly used typical medications include:
Perphenazine (Etrafon, Trilafon)
In the 1990's, new antipsychotic medications were
developed. These new medications are called second
generation, or "atypical" antipsychotics.
One of these medications, clozapine (Clozaril) is an
effective medication that treats psychotic symptoms,
hallucinations, and breaks with reality. But
clozapine can sometimes cause a serious problem
called agranulocytosis, which is a loss of the white
blood cells that help a person fight infection.
People who take clozapine must get their white blood
cell counts checked every week or two. This problem
and the cost of blood tests make treatment with
clozapine difficult for many people. But clozapine
is potentially helpful for people who do not respond
to other antipsychotic medications.
Other atypical antipsychotics were also developed.
None cause agranulocytosis. Examples include:
What are the side effects?
Some people have side effects when they start taking
these medications. Most side effects go away after a
few days and often can be managed successfully.
People who are taking antipsychotics should not
drive until they adjust to their new medication.
Side effects of many antipsychotics include:
Dizziness when changing positions
Sensitivity to the sun
Menstrual problems for women.
Atypical antipsychotic medications can cause major
weight gain and changes in a person's metabolism.
This may increase a person's risk of getting
diabetes and high cholesterol. A person's weight,
glucose levels, and lipid levels should be monitored
regularly by a doctor while taking an atypical
Typical antipsychotic medications can cause side
effects related to physical movement, such as:
Persistent muscle spasms
Long-term use of typical antipsychotic medications
may lead to a condition called tardive dyskinesia
(TD). TD causes muscle movements a person can't
control. The movements commonly happen around the
mouth. TD can range from mild to severe, and in some
people the problem cannot be cured. Sometimes people
with TD recover partially or fully after they stop
taking the medication.
TD happens to fewer people who take the atypical
antipsychotics, but some people may still get TD.
People who think that they might have TD should
check with their doctor before stopping their
How are antipsychotics taken and how do people
respond to them?
Antipsychotics are usually in pill or liquid form.
Some anti-psychotics are shots that are given once
or twice a month.
Symptoms of Schizophrenia, such as feeling agitated
and having hallucinations, usually go away within
days. Symptoms like delusions usually go away within
a few weeks. After about six weeks, many people will
see a lot of improvement.
However, people respond in different ways to
antipsychotic medications, and no one can tell
beforehand how a person will respond. Sometimes a
person needs to try several medications before
finding the right one. Doctors and patients can work
together to find the best medication or medication
combination, as well as the right dose.
Some people may have a relapse-their symptoms come
back or get worse. Usually, relapses happen when
people stop taking their medication, or when they
only take it sometimes. Some people stop taking the
medication because they feel better or they may feel
they don't need it anymore. But no one should stop
taking an antipsychotic medication without talking
to his or her doctor. When a doctor says it is okay
to stop taking a medication, it should be gradually
tapered off, never stopped suddenly.
How do antipsychotics interact with other
Antipsychotics can produce unpleasant or dangerous
side effects when taken with certain medications.
For this reason, all doctors treating a patient need
to be aware of all the medications that person is
taking. Doctors need to know about prescription and
over-the-counter medicine, vitamins, minerals, and
herbal supplements. People also need to discuss any
alcohol or other drug use with their doctor.
To find out more about how antipsychotics work, the
National Institute of Mental Health (NIMH) funded a
study called CATIE (Clinical Antipsychotic Trials of
Intervention Effectiveness). This study compared the
effectiveness and side effects of five
antipsychotics used to treat people with
Schizophrenia. In general, the study found that the
older typical antipsychotic perphenazine (Trilafon)
worked as well as the newer, atypical medications.
But because people respond differently to different
medications, it is important that treatments be
designed carefully for each person.
II. PSYCHOSOCIAL TREATMENTS
Psychosocial treatments can help people with
Schizophrenia who is already stabilized on
antipsychotic medication. Psychosocial treatments
help these patients deal with the everyday
challenges of the illness, such as difficulty with
communication, self-care, work, and forming and
keeping relationships. Learning and using coping
mechanisms to address these problems allow people
with Schizophrenia to socialize and attend school
Patients who receive regular psychosocial treatment
also are more likely to keep taking their
medication, and they are less likely to have
relapses or be hospitalized.
A therapist can help
patients better understand and adjust to living with
Schizophrenia. The therapist can provide education
about the disorder, common symptoms or problems
patients may experience, and the importance of
staying on medications.
Psychosocial treatment help patients deal with their
illness from day to day. The treatments are helpful
after patients find a medication that works.
- 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
- Illness management skills:
ways for the patient to
learn about the illness and manage it from day to
help with getting a job and
everyday living skills
- Self-help groups:
support from other people with
the illness and their families
talking with a therapist about living
with the illness and learning how to manage
symptoms, like hearing voices or having delusions.
Illness Management Skills:
People with Schizophrenia
can take an active role in managing their own
illness. Once patients learn basic facts about
Schizophrenia and its treatment, they can make
informed decisions about their care. If they know
how to watch for the early warning signs of relapse
and make a plan to respond, patients can learn to
prevent relapses. Patients can also use coping
skills to deal with persistent symptoms.
Integrated Treatment for Co-occurring Substance
Substance abuse is the most common
co-occurring disorder in people with Schizophrenia.
But ordinary substance abuse treatment programs
usually do not address this population's special
needs. When Schizophrenia treatment programs and
drug treatment programs are used together, patients
get better results.
Rehabilitation emphasizes social and
vocational training to help people with
Schizophrenia function better in their communities.
Because Schizophrenia usually develops in people
during the critical career-forming years of life
(ages 18 to 35), and because the disease makes
normal thinking and functioning difficult, most
patients do not receive training in the skills
needed for a job.
Rehabilitation programs can include job counseling
and training, money management counseling, help in
learning to use public transportation, and
opportunities to practice communication skills.
Rehabilitation programs work well when they include
both job training and specific therapy designed to
improve cognitive or thinking skills. Programs like
this help patients hold jobs, remember important
details, and improve their functioning.
Family Education:People with Schizophrenia are often
discharged from the hospital into the care of their
families. So it is important that family members
know as much as possible about the disease. With the
help of a therapist, family members can learn coping
strategies and problem-solving skills. In this way
the family can help make sure their loved one sticks
with treatment and stays on his or her medication.
Families should learn where to find outpatient and
Cognitive Behavioral Therapy:Cognitive behavioral
therapy (CBT) is a type of psychotherapy that
focuses on thinking and behavior. CBT helps patients
with symptoms that do not go away even when they
take medication. The therapist teaches people with
Schizophrenia how to test the reality of their
thoughts and perceptions, how to "not listen" to
their voices, and how to manage their symptoms
overall. CBT can help reduce the severity of
symptoms and reduce the risk of relapse.
Self-help Groups:Self-help groups for people with
Schizophrenia and their families are becoming more
common. Professional therapists usually are not
involved, but group members support and comfort each
other. People in self-help groups know that others
are facing the same problems, which can help
everyone feel less isolated. The networking that
takes place in self-help groups can also prompt
families to work together to advocate for research
and more hospital and community treatment programs.
Also, groups may be able to draw public attention to
the discrimination many people with mental illnesses