Schizophrenia and Other Psychotic Disorders
How Are Psychotic Disorders Diagnosed?
If symptoms of a psychotic disorder are present, the doctor will perform a complete medical history and physical exam to determine the cause of the symptoms. Although there are no laboratory tests to specifically diagnose psychotic disorders -- except those that accompany a physical illness, such as a brain tumor -- the doctor may use various tests, such as blood tests and brain imaging (e.g., MRI scans), to rule out physical illness or intoxication with drugs like cocaine or LSD as the cause of the symptoms.
If the doctor finds no physical reason for the symptoms, he or she may refer the person to a psychiatrist or psychologist, mental health professionals who are trained to diagnose and treat mental illnesses. Psychiatrists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder.
How Are Psychotic Disorders Treated?
Most psychotic disorders are treated with a combination of medications and psychotherapy (a type of counseling).
Medication: The main medications used to treat psychotic disorders are called antipsychotics. These medicines do not cure the illnesses, but are very effective in managing the most troubling symptoms of psychotic disorders, such as delusions, hallucinations, and thinking problems. So-called "typical" or "first-generation" antipsychotics include medications such as chlorpromazine (Thorazine), fluphenazine (Prolixin), haloperidol (Haldol), loxapine(Loxapine), perphenazine (Trilafon), and thioridazine (Mellaril). Newer "atypical antipsychotics" include aripiprazole (Abilify), asenapine (Saphris), brexpiprazole (Rexulti), cariprazine (Vraylar), clozapine (Clozaril), iloperidone (Fanapt), lurasidone (Latuda), paliperidone (Invega), paliperidone palmitate (Invega Sustenna or Invega Trinza), quetiapine (Seroquel),risperidone (Risperdal), olanzapine (Zyprexa), and ziprasidone (Geodon).
The atypical psychotics are often considered first-line treatments because they have fewer and more tolerable side effects than do the typical antipsychotics. Some of the medications are available by injection and only need to be taken once or twice a month. For patients this can be easier to keep up with compared to a daily pill.
Psychotherapy: Various types of psychotherapy, including individual, group, and family therapy, may be used to help support the person with a psychotic disorder.
Most patients with psychotic disorders are treated as outpatients. However, people with particularly severe symptoms, those in danger of hurting themselves or others, or those unable to care for themselves because of their illness, may require hospitalization to stabilize their condition.