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Treatment

Reviewed by: HU Medical Review Board | Last reviewed: August 2023

There is no single cure for schizophrenia. However, there are many parts of a successful treatment plan. Prescription drugs, lifestyle changes, therapy, and more all come together to help improve quality of life for people with this condition.1

Who treats schizophrenia?

Several health experts may be involved in treating schizophrenia. In most cases, your primary care doctor will start the initial work toward diagnosis. They then refer you to a psychiatrist. This is a doctor who specializes in mental health diagnosis and treatment.2,3

A psychiatrist often serves as the head of the care team. Depending on your symptoms and needs, other experts may be involved, too. Each one has a different role. Some of the most common other team members for treating schizophrenia are:3-5

  • Psychologists
  • Mental health nurses
  • Psychiatric nurse practitioners
  • Mental health counselors or other therapists
  • Social workers
  • Case managers
  • Pharmacists
  • Occupational or physical therapists
  • Nutritionists or dietitians

Where are people with schizophrenia treated?

People with schizophrenia can be treated in a variety of places. Contrary to one myth, they are not always treated in the hospital. Some people with schizophrenia who have well-controlled symptoms will never need to be hospitalized. There are several levels of care available.6

People living with schizophrenia may be treated at home and have regular follow-up visits with their healthcare team. This is called outpatient care. There are also intensive outpatient and partial hospitalization programs. With these options, you live at home but you spend more time each week receiving treatment or therapy. In rare cases where symptoms are most severe, you may need the support of a residence or hospital for some period of time.7,8

Community-based care options

Community-based care options combine a variety of health experts who can give care at home and help coordinate if you are receiving inpatient care. You often can access these teams any time of the day, including in crisis situations.9,10

Common community-based care options are coordinated specialty care (CSC) and assertive community treatment (ACT). You and your healthcare team will work together to determine which levels of care and/or community-based options are right for you.9,10

Antipsychotic drugs

Antipsychotic drugs are the gold standard for treating schizophrenia. These drugs help reduce the “positive” symptoms of schizophrenia. Positive symptoms include symptoms of psychosis, like hallucinations, delusions, or disorganized thinking.11-13

Some antipsychotic drugs may impact “negative” symptoms, too. Negative symptoms are typically persistent in between and even during psychosis episodes. They include a lack of motivation, pleasure, or desire to socialize. These symptoms can greatly affect day-to-day quality of life.11-13

Antipsychotic drugs are grouped into first-generation (typical) and second-generation (atypical) antipsychotics. Second-generation drugs are newer and are thought to have fewer side effects. They may also be more effective in some cases.11-13

These drugs do carry some risks, though. One possible serious side effect of atypical antipsychotics is called metabolic syndrome. This is a change in the way your body processes fats and sugars. It can lead to weight gain and a higher risk of developing diabetes and heart disease.11-13

Clozapine for treatment-resistant schizophrenia

One second-generation antipsychotic drug, clozapine, has had promising results in treating treatment-resistant schizophrenia. In the past, hospitalization and electroconvulsive therapy (ECT) were the main options for people who did not respond to drug therapy. However, these options can be disruptive to a person’s day-to-day life.1,13

With clozapine, symptom improvement may be possible for more people than ever before. People taking this drug may not need higher levels of care. But clozapine has potentially serious side effects which need to be monitored through regular bloodwork. You and your doctor will discuss whether it is the best option in your case.13

Psychosocial therapies

Psychosocial therapies are a part of nearly every treatment plan for schizophrenia. These therapies are used alongside drugs. They can address symptoms of schizophrenia, general mental health, and stress. Some may even include other family members or caregivers so they can work through the challenges of caring for someone living with schizophrenia.14,15

Psychosocial therapies can target both positive and negative symptoms. They are used throughout a person’s journey with the condition. Some can be done at home or online. Others occur in a more formal setting.14,15

Common psychosocial therapies for schizophrenia include:9,14,15

  • Cognitive behavioral therapy (CBT)
  • Creative therapy (like art or music)
  • Family therapy
  • Peer counseling
  • Social skills training
  • Employment or school support
  • Support groups (in person or online)

Complementary and integrative medicine

Complementary therapy refers to methods that may be used alongside traditional treatment options like prescribed drugs. Integrative medicine refers to a holistic treatment plan that includes traditional and complementary options to treat overall well-being. A strong integrative treatment plan for schizophrenia includes drug therapy, psychosocial interventions, and complementary methods that feel helpful.16,17

Some complementary options, like vitamins and supplements, have risks even with natural and/or herbal supplements. These include potential interactions with antipsychotic drugs. Also, it is important to know that vitamins and supplements are not regulated in the same way as drugs are in the United States. Supplements often do not have research supporting their claims.16

Some mind-body complementary therapies, like acupuncture, need to be performed by a trained professional. Look into the credentials of the person performing the therapy before starting certain complementary treatments.16

Talk with your doctor before starting any complementary treatment option and tell your doctor if you are taking any over-the-counter supplements. They can help determine what is safe in your case.

Lifestyle changes

Along with integrative treatment planning, general lifestyle changes also can be helpful. Some people refer to these lifestyle changes as “self-management” of schizophrenia.17,18

Many of these changes help promote well-being. Others reduce the risk of developing other, common co-occurring health issues. An example is quitting smoking to reduce the risk of developing heart disease.17,18

Common lifestyle changes made by people living with schizophrenia include:17,18

  • Eating a well-balanced diet
  • Drinking plenty of water
  • Exercising regularly
  • Quitting smoking
  • Getting good sleep and practicing regular, healthy nighttime routines
  • Avoiding alcohol and recreational drugs

Before beginning treatment for schizophrenia, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

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