Treatment

There is no single cure for schizophrenia. However, treatment can help reduce symptoms. There are many parts of a successful treatment plan. Prescription drugs, lifestyle changes, and therapy all can help improve quality of life.¹

Who treats schizophrenia?

Several health experts are involved in treatment. In most cases, your primary care doctor will start the initial diagnosis. They then will 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 a care team. Your symptoms and needs will determine which other experts are part of the team. Each one has a different role. Some common care team members 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 many places. Contrary to myth, they are not always treated in the hospital. Some people who have well-controlled schizophrenia symptoms will never need to be hospitalized.⁶

Several levels of care are available. People living with schizophrenia may be treated at home. They may then have regular visits with their healthcare team. This is called outpatient care.^7,8

Other options include intensive outpatient and partial hospitalization programs. With these options, you live at home but spend more time receiving treatment or therapy. In rare cases where symptoms are severe, you may need the support of a special residence or hospital.^7,8

Community-based care options

Community-based care options involve health experts who provide care at home and during inpatient care. You often can access these teams any time of day, including in crisis situations. Two common options are coordinated specialty care (CSC) and assertive community treatment (ACT).^9,10

Antipsychotic drugs

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

Some antipsychotic drugs may help with “negative” symptoms too. Negative symptoms typically occur in between and during psychosis episodes. They include a lack of motivation, pleasure, or desire to socialize. They also may reduce people’s ability to do basic daily tasks like bathing. These symptoms greatly affect day-to-day quality of life.^11-13

Antipsychotic drugs are classified as either first-generation (typical) or second-generation (atypical). Second-generation drugs are newer and have fewer side effects. They may also be more effective in some cases.^11-13

Some people with schizophrenia do not respond well to drug therapy. One second-generation drug, clozapine, may work for these people. In the past, hospitalization and electroconvulsive therapy (ECT) were the main options in these cases.^1,13

Muscarinic agonists

Muscarinic agonists are a newer way to treat schizophrenia. These drugs target muscarinic acetylcholine receptors instead of dopamine receptors. Activating muscarinic receptors in the brain can help reduce positive and negative symptoms. Muscarinic agonists are combined with other drugs to reduce side effects. It is also important to take them on an empty stomach.¹⁴

Electroconvulsive therapy

ECT may be used to treat people who do not respond to any medicines. It is used only for severe schizophrenia symptoms. During ECT, small electric currents are sent to the brain. The electricity causes a small seizure. This can change the balance of brain chemicals to reduce symptoms. ECT is a safe treatment, and you are monitored by a healthcare provider the whole time.¹

Psychosocial therapies

Psychosocial therapies are 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.^15,16

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.^15,16

Some therapies also may include other family members or caregivers. This can help them work through the challenges of caring for someone living with schizophrenia.^15,16

Common psychosocial therapies for schizophrenia include:^9,15,16

• Cognitive behavioral therapy (CBT)
• Creative therapy (like art or music therapy)
• 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 used alongside traditional treatment options. Integrative medicine refers to a holistic plan to treat overall well-being. A strong integrative treatment plan for schizophrenia may include medicines, psychosocial therapy, and other methods that feel helpful.¹⁷

One complementary option is dietary supplements, including vitamins and herbs. But these can have risks, like interacting with antipsychotic drugs. Also, supplements may not have research supporting their claims. They also are not regulated like other drugs.¹⁷

Mind-body therapies, like meditation, yoga, and tai chi, may be helpful as well. Some of these therapies, such as biofeedback and hypnosis, need to be performed by a trained professional. Look into the credentials of the therapist before starting therapy.¹⁷

Lifestyle changes

General lifestyle changes help many people manage their schizophrenia symptoms. Some people refer to these lifestyle changes as self-management.¹⁸

Many lifestyle changes help promote well-being. Others reduce the risk of common co-occurring health issues. For example, quitting smoking can reduce the risk of drug interactions, heart disease, and other serious health conditions.¹⁸

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

• Eating a well-balanced diet
• 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.