Schizophrenia Treatment:Types of Therapies and Medication

Reviewed by Jennifer Casarella on March 04, 2021

 

Schizophrenia is a serious mental illness that affects your thinking, emotions, relationships, and decision making. And because there’s no cure, getting the proper treatment early is the best way to improve chances of managing the illness.

Schizophrenia treatment will center on managing your symptoms. You may need to stay on medication for a long time, possibly even for life. Psychotherapy, a kind of talk therapy, will likely also be a big part of the plan to help you understand and manage your symptoms. The right treatments, along with practical and emotional support from your loved ones, will go a long ways to help you navigate your life.

Types of Psychotherapy

Individual psychotherapy. During sessions, a therapist or psychiatrist can teach the person how to deal with their thoughts and behaviors. They’ll learn more about their illness and its effects, as well as how to tell the difference between what’s real and what’s not. It also can help them manage everyday life. Learn more about the different types of psychotherapy.

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Cognitive behavior therapy (CBT). This can help the person change their thinking and behavior. A therapist will show them ways to deal with voices and hallucinations. With a combination of CBT sessions and medication, they can eventually tell what triggers their psychotic episodes (times when hallucinations or delusions flare up) and how to reduce or stop them. Read more on how cognitive behaioral therapy can help thinking patterns.

Cognitive enhancement therapy (CET). This type of therapy is also called cognitive remediation. It teaches people how to better recognize social cues, or triggers, and improve their attention, memory, and ability to organize their thoughts. It combines computer-based brain training and group sessions.

Types of Psychosocial Therapy

If a person with schizophrenia sees improvement during psychotherapy sessions, it’s likely they’ll need more help learning how to become part of a community. That’s where psychosocial therapy comes in.

Social skills training. This type of instruction focuses on improving communication and social interactions.

Rehabilitation. Schizophrenia usually develops during the years we are building our careers. So rehabilitation may include job counseling, problem-solving support, and education in money management.

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Family education. Your knowledge of psychosis and schizophrenia can help a friend or family member who has it. Research shows that people with schizophrenia who have a strong support system do better than those without the encouragement of friends and family.

Self-help groups. You should encourage your loved one to participate in community care and outreach programs to continue working on their social skills. The National Alliance on Mental Illness (NAMI) is an outreach organization that offers a free peer-to-peer program, for instance. It includes 10 sessions for adults with mental illness who want to learn more about their condition from people who have experienced it themselves or been through it with a loved one.

Coordinated specialty care (CSC). This is for people experiencing an episode of psychosis for the first time. It’s a team approach that combines medication and psychological therapies. It includes social and employment services and tries to include the family whenever possible. The aim is to change the direction and prognosis for the disease by catching it in its earliest stages. Research shows that people with schizophrenia who get early and intensive treatment have the best long-term results.

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Assertive community treatment (ACT). This offers highly personalized services to help people with schizophrenia meet life’s daily challenges, like taking medications. ACT professionals also help them handle problems proactively and work to prevent crises.

Social recovery therapy. This treatment puts the focus on helping the person set and achieve goals and building a sense of optimism and positive beliefs about themselves and others.

Newer Antipsychotic Drugs

These are also called second-generation or atypical antipsychotics. They’re newer than the first-generation drugs. They generally cause fewer side effects, such as repetitive or involuntary movements like eye blinking, than older antipsychotics. Medications include:

Second-generation antipsychotics work about equally as well as older drugs. The one exception is clozapine, which is effective against schizophrenia that doesn’t respond to other treatments.

Side effects. Different atypical antipsychotics may cause different side effects. Your doctor will help you pick a drug that works best for you with the minimum amount of adverse effects. Some common issues may include:

  • Weight gain
  • Higher blood sugar and cholesterol levels
  • Low blood pressure
  • Drowsiness
  • Type 2 diabetes
  • Constipation
  • Blurry vision
  • Dry mouth

First-Generation Antipsychotic Drugs

You might hear these drugs called typical or conventional. These medications block a brain chemical called dopamine and are more likely than second-generation antipsychotics to cause significant movement disorders like intense muscle stiffness (called dystonia) or a condition that may develop over long-term exposure called tardive dyskinesia. Drugs in this group include:

Ways to take the medication. Most antipsychotics are pills you take by mouth. Several drugs come in tablets that dissolve easily in your mouth. If you have trouble taking pills every day, you can get shots for several second-generation antipsychotics. These long-acting drugs require injections every couple of weeks to every 3 months. They include aripiprazole, haloperidol, olanzapine, paliperidone, and risperidone.

Electroconvulsive Therapy (ECT)

In this procedure, electrodes are attached to the person's scalp. While they’re under general anesthesia, doctors send a small electric shock to the brain. A course of ECT therapy usually involves 2-3 treatments per week for several weeks. Each shock treatment causes a controlled seizure. A series of treatments over time leads to improvement in mood and thinking. Scientists don’t fully understand exactly how ECT and the controlled seizures it causes help, although some researchers think that ECT-induced seizures may affect the release of neurotransmitters in the brain. It can help when medications no longer work or if severe depression or catatonia makes treating the illness difficult. Find out more on how electroconvulsive therapy works.

Living With Schizophrenia

Most people with this condition do get better with treatment and support. Exercise, eat healthy foods, manage your stress, and stay connected with your loved ones. Staying mentally and physically strong can help you feel more in charge of your illness and your life.

WebMD Medical Reference

Sources

SOURCES:

National Institute of Mental Health: "How Is Schizophrenia Treated?" "What Is Schizophrenia?" "Schizophrenia."

National Alliance on Mental Illness: "Treatment, Services, and Support," “Peer to Peer,” “Schizophrenia.”

National Guideline Alliance: "Psychosis and schizophrenia in adults: treatment and management.”

Mayo Clinic: “Schizophrenia.”

Schizophrenia Research: “Social Recovery Therapy in improving activity and social outcomes in early psychosis: Current evidence and longer term outcomes.”

UpToDate: “Selected adverse effects of antipsychotic medications for schizophrenia,” “Second-generation antipsychotic medications: Pharmacology, administration, and side effects.”

Johns Hopkins Medicine: “Frequently Asked Questions about ECT.”

American Family Physician: “Adverse Effects of Antipsychotic Medications.”

National Health Service (UK): “Living with Schizophrenia.”

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