Treatment of schizophrenia is lifelong in most cases. Note, this is so even after the symptoms subside. It can be difficult to cope with schizophrenia. And, most find it devastating to be handed a diagnosis of schizophrenia. This is because, this mental illness will disorder your thinking, emotions, relationships, and even daily functioning and decision-making. However, with proper treatment, you can still live a full and meaningful life. Although as of now there is no cure for schizophrenia, you can manage it with medication, psychotherapy, psychosocial therapy, and self-help strategies.
How to Treat Schizophrenia: Medications
Medications are the main way of treating schizophrenia. And, the most commonly prescribed drugs for this illness are antipsychotics. This is because, psychotic symptoms are prominent in schizophrenia, such as delusions (fixed beliefs with no basis in reality) and hallucinations (seeing or hearing things that aren’t there). Presumably, these drugs work by blocking the action of the neurotransmitter dopamine. And, a neurotransmitter is a naturally occurring chemical in the brain that facilitates signal transmission between nerve cells.
The psychiatrist will try different drugs in different doses and combinations before finding the one that works best for you. Other medications that can help are anti-anxiety drugs or antidepressants. But, it can take several weeks for symptoms to improve.
These medications can have serious side effects. So, you may find that patients with schizophrenia will be reluctant to take them. Sometimes, they may even stop taking medications altogether. In such cases of risk of non-compliance, give injections instead of pills.
They are also called atypical antipsychotics and were first developed in the 1990s. These medications pose a lower risk of serious side effects than do first-generation antipsychotics. Second-generation antipsychotics include:
- Aripiprazole (Abilify)
- Asenapine (Saphris)
- Brexpiprazole (Rexulti)
- Cariprazine (Vraylar)
- Clozapine (Clozaril)
- Iloperidone (Fanapt)
- Lurasidone (Latuda)
- Olanzapine (Zyprexa)
- Paliperidone (Invega)
- Pimavanserin (Nuplazid)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
- Ziprasidone (Geodon)
They are also called typical antipsychotics and were first developed in the 1950s. These have significant neurological side effects, including a movement disorder (tardive dyskinesia) that may not be reversible. First-generation antipsychotics include:
- Chlorpromazine (Thorazine)
- Fluphenazine (Prolixin)
- Haloperidol (Haldol)
- Loxapine (Loxitane)
- Perphenazine (Trilafon)
- Pimozide (Orap)
- Thiothixene (Navane)
- Trifluoperazine (Stelazine)
These are perhaps preferable when long-term treatment is necessary because they are cheaper.
Some antipsychotics can be given as an intramuscular or subcutaneous injection. Usually, they are given every 2-4 weeks. This option is preferable when someone does not like to take pills or there is a risk of non-compliance to oral medication.
Antipsychotics available as an injection include:
- Aripiprazole (Abilify Maintena, Aristada)
- Fluphenazine decanoate
- Haloperidol decanoate
- Paliperidone (Invega Sustenna, Invega Trinza)
- Risperidone (Risperdal Consta, Perseris)
Side Effects of Antipsychotics
Side effects of both typical and atypical antipsychotics include:
- Dry mouth
- Blurred vision
- Weight gain
- Loss of libido
The side effects of typical antipsychotics also include:
- Muscle twitches
- Muscle spasms
Duration of Antipsychotic Therapy
How long you need to take antipsychotic medication depends on your symptoms. Some people need to keep taking it long-term.
If you had only one psychotic episode from which you have recovered, then you need to continue treatment for 1–2 years after recovery.
If there is another psychotic episode, you should take the medication for up to 5 years. This is because the risk of relapse is high if treatment is stopped in such cases.
People who have had several psychotic episodes need to take the medications lifelong.
How to Treat Schizophrenia: Psychotherapy
Individual psychotherapy involves regularly scheduled talks between the patient and a mental health professional such as a psychiatrist or clinical psychologist. The sessions may focus on current or past problems, thoughts, feelings, experiences, or relationships. During sessions, the therapist can teach the person how to deal with their thoughts and behaviors. Thus, psychotherapy may normalize thought patterns. In addition, they’ll learn how to tell the difference between what’s real and what’s not. Also, learning to cope with stress and identifying early warning signs of relapse can help people with schizophrenia manage their illness.
Cognitive-Behavioral Therapy (CBT)
CBT can help the person identify wrong thinking patterns that are leading to unwanted behaviors and feelings. Then, they will learn to replace such thoughts with more useful and realistic thoughts. A therapist will show them ways to deal with delusions and hallucinations. For example, you may be taught to recognize examples of delusional thinking and how to avoid acting on these thoughts.
The duration of CBT sessions is usually an hour. Most people require several sessions over a number of months.
Cognitive Enhancement Therapy (CET) / Cognitive Remediation
Cognitive remediation programs teach people how to better recognize social cues. They can help you improve your attention, memory, and organization of thoughts. Some programs also help you interact better with other people. These programs usually combine computer-based brain training and group sessions.
How to Treat Schizophrenia: Psychosocial Therapy
If a patient with schizophrenia shows improvement with psychotherapy, they can be further helped to become part of a community. Enter psychosocial therapy.
Social Skills Training
This focuses on improving communication and social interactions. Also, it improves the ability to participate in daily activities. It uses the principles of behavior therapy to teach skills related to communication, assertiveness, disease management and independent living. Skills are learned in small groups by role-plays and repeated practice.
Vocational Rehabilitation and Supported Employment
This involves job counseling and lessons on problem-solving and money management skills. It tries to help people with schizophrenia prepare for, find and keep jobs. Also, social and vocational training is imparted in psychosocial rehab. Also, skills are taught on how to interact with others and live in the community.
Family therapy helps you and your family deal better with schizophrenia. In this, informal meetings are held over a period of 6 months. Meetings include discussing information about schizophrenia, exploring ways of supporting somebody with schizophrenia and deciding how to solve practical problems caused by schizophrenia.
Self-help Strategies in the Treatment of Schizophrenia
Coping with schizophrenia is a lifelong process. Even if you recover, you can experience a relapse of symptoms or more challenges from the illness. But, you learn to manage your symptoms, utilize the support offered, and create a satisfying and purpose-driven life.
Self-help strategy is another way how you treat schizophrenia. A schizophrenia treatment plan that combines self-help strategies with medication, psychotherapy and supportive services is the most effective approach.
Join a Support Group
Support groups make you feel less alone. Group members offer each other acceptance, advice and emotional support. Moreover, some groups carry on advocacy efforts to fight stigma and improve the overall lives of all people suffering from this illness. By speaking to other schizophrenics, one gains further and deeper understanding and perspective on their illness.
Regular exercise can lessen your symptoms of schizophrenia. It improves your focus, relieves stress, gives you more energy, helps you sleep better, and makes you feel calmer. However, this does not mean you have to become a fitness freak. Brisk walking daily for 30 min at least 5 days a week would suffice. Other aerobic exercises like running, swimming, or dancing, can be very effective in calming down your nervous system.
Stress can drain you and make you feel worse if you have schizophrenia. Unfortunately, with modern lifestyle stress has become inevitable. So, it is important that you learn to manage and handle stress. Know your limits, and do not take on more work or chores than you can handle comfortably. Use relaxation techniques, such as progressive muscle relaxation, deep breathing, yoga, and mindfulness meditation, to relieve stress. Lastly, manage your emotions better by understanding and accepting them.
Eat a healthy and balanced diet. Try to get plenty of restful sleep. If need be, avoid caffeine, especially at bedtime. Avoid alcohol and drugs because substance abuse can worsen the symptoms of schizophrenia.
How to Treat Schizophrenia: Hospitalization
Acute and severe episodes need hospitalization. This will ensure safety, and proper nutrition, sleep, and basic hygiene.
Electroconvulsive Therapy in the Treatment of Schizophrenia
Consider electroconvulsive therapy (ECT) in adults with schizophrenia not responding to treatment. Moreover, ECT is also useful if someone has concomitant depression.