How to treat schizophrenia

Medications and therapy can help a person with schizophrenia to live a good quality of life, achieve personal goals and feel fulfilled. If you receive a diagnosis of schizophrenia, you will likely need treatments for the rest of your life.

According to the World Health Organization (WHO), schizophrenia affects 1 in 300 people worldwide. Schizophrenia tends to emerge earlier in age for males, in their early 20s or late teens. For females, this is later in their early 20s to early 30s.

Your doctor will create a treatment plan tailored to your individual needs. Many of the available treatments are very effective, and at least 1 in 3 people with schizophrenia will be able to live a good quality of life.

This article explores the different treatment options that your doctor may recommend to help manage symptoms of schizophrenia.

Medication

A doctor may recommend antipsychotic medications to help manage your symptoms. These medications work by affecting how your brain receives the neurotransmitter dopamine. By managing dopamine overactivity, symptoms of psychosis, like delusions, can be less prevalent in your mind. Medications can come as pills or in liquid form.

There are two types of drugs for schizophrenia:

• first-generation medications
• second generation medications

Some first-generation medications include:

• trifluoperazine (Stelazine)
• fluphenazine (Prolixin)
• loxapine (Loxitane)
• thiothixene (Navene)
• molindone (Moban)

Some side effects from first-generation medications can include:

• constipation
• dry mouth
• abnormal heart rhythm
• dermatitis

Some second-generation medications come as extended-release medications. Some second-generation medications include:

• risperidone (Risperdal)
• paliperidone (Invega)
• clozapine (Clozaril)
• quetiapine (Seroquel)
• ziprasidone (Geodon)
• asenapine (Saphris)
• brexpiprazole (Rexulti)

Second-generation medications have different side effects from first-generation medications. The effects will depend on the drug.

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Therapy treatments

There are various therapeutic options that may help to manage schizophrenia symptoms.

Psychosocial treatments

Psychosocial therapy for schizophrenia is important, both as stand-alone treatments and as complementary to medications. Some benefits of therapy include:

• improving daily function and management of emotional stress
• treatment of depression symptoms
• treatment of anxiety symptoms
• learning sustainable coping skills

Different kinds of therapy exist, so finding the right one for you is important.

Some types, like cognitive behavior therapy (CBT), help you identify thought patterns that are most significant to your condition. This type of therapy enables you to create systems to minimize these patterns and give you back control over your emotional state.

Social skills training

These skills can help you feel comfortable in social situations while managing schizophrenia symptoms. This kind of therapy can include roleplaying with a professional to make you feel comfortable in a variety of social situations.

Electroconvulsive therapy (ECT)

Although typically for managing symptoms of severe depression, ECT is effective for treating schizophrenia. Your doctor may recommend this procedure if you do not respond to other forms of treatment, such as medications.

ECT is the stimulation of a person’s brain using controlled electrical pulses. How this works to treat mental health conditions is unknown. It may trigger short-term memory loss and nausea after the procedure, but memory typically returns in the following weeks.

Family support and education

Therapy and guidance for your family members can help make your treatment for schizophrenia smoother and easier.

Family support and education focuses on ensuring they understand the condition so they can assist you effectively. It can help family members:

• understand schizophrenia and the associated challenges
• lower their stress levels
• develop ways of communicating with someone with schizophrenia
• keep their expectations for treatment reasonable

Occupational support

This is an important step in schizophrenia treatment, as it can make it easier to return to work after or even during treatment. Employment can help with treatment, as it encourages feelings of normality and encourages meaningful activity.

Support during a return to employment can involve specialized role development, job searches, or continued support.

You may not be feeling ready to return to work, but still think it will be the right decision in the future. In these instances, volunteering can be useful to help you regain the skills to feel comfortable in a workplace but without as much pressure.  

Summary

Treatments for schizophrenia typically involve both medications and therapy. Treatments are highly individual, and your doctor will create a plan that best suits your needs.

Antipsychotic medications are the primary clinical treatment for schizophrenia. You will work with your doctor to find the best type for you. Different types of therapy are important in helping you adjust to different aspects of life — for example, the workplace.  

If someone you know with schizophrenia is refusing treatment, try to have a calm, open and honest conversation with them about why they are doing so, and why you have concerns.

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