Schizophrenia treatment typically consists of medication and psychological and functional counseling. While skills and other types of therapy are useful, medication is still the cornerstone of the treatment of schizophrenia. Psychiatrists, therapists, counselors, social workers, dieticians and others may all be involved in treating schizophrenia.
Schizophrenia Treatment: Medication
Schizophrenia is treated with antipsychotic medication designed to drastically reduce and hopefully stop the symptoms of psychosis (hallucinations and delusions). Within one year, only 20% of people on antipsychotic medication will relapse compared to 80% of those who have stopped antipsychotic medication treatment.
There are no clear schizophrenia treatment guidelines about which antipsychotic to try first. However, factors that go into the decision include:
- Adherence likelihood
- Side effects (tolerability)
- Method of delivery (such as oral or injection)
Schizophrenia and Treatment with Antipsychotic Medication
The main choice in antipsychotic schizophrenia treatment is whether to use a first or second generation antipsychotic. Most often, the doctor will select a second generation antipsychotic medication called an ayptical antipsychotic. First generation antipsychotics (conventional, or typical antipsychotics) are not normally the first choice to treat schizophrenia due to side effects that can severely affect body movements; however, those who do not respond to second generation antipsychotics (atypical antipsychotics) may respond to first generation antipsychotics.1
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First generation antipsychotics are known to induce movement disorders (tardive dyskensia) in more than 1-in-3 patients and some of these movement disorders may be permanent, even after the medication is stopped. Movement side effects can include:
- Inner restlessness
- Painful muscle cramps
- Involuntary and repetitive movements
First generation antipsychotics are also known to be related to high levels of prolactin (a hormone) in the blood, as well as a severe neurological side effect known as neuroleptic malignant syndrome (NMS). Blood tests are often required to check for possible problems with this type of schizophrenia treatment.
Atypical antipsychotic schizophrenia treatment is associated with weight gain as well as blood sugar and cholesterol issues. People on these medications can develop type 2 diabetes. Movement disorders can also occur with this type of schizophrenia treatment but they are far less prevalent.
Other Types of Schizophrenia Treatments
Other types of schizophrenia treatment are known as psychosocial interventions. It’s important to treat schizophrenia with this type of therapy, as medication alone isn’t normally sufficient to increase the level of functioning of a person with schizophrenia. The therapies most studied for schizophrenia include:
- Skills training
- Cognitive behavioral therapy (CBT) – a type of psychotherapy focused on building skills and changing behaviors
- Cognitive remediation – uses brain exercises to improve the cognitive impairment typical in schizophrenia
- Social cognition training – focuses on creating an understanding of social relationships and interactions
Individual and family therapy can also be useful schizophrenia treatments, as schizophrenia often affects everyone in a family. Vocational rehabilitation and supported employment are also common parts of schizophrenia treatment.
Support organizations and support groups can also be helpful in schizophrenia treatment. Many communities have programs to help people with schizophrenia get access to housing and other services. This provides them with the best opportunity at successful independent living in the community. Social workers can also be helpful in this area. 2