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The causes of schizophrenia are unknown, so treatments are aimed at managing symptoms. There is no known cure for schizophrenia. However, we have come a long way in treatment methods. In early times, people who likely suffered from schizophrenia were often shut away in prison-like institutions. With today’s treatments, patients can still create a relatively good quality of life.
Antipsychotic drugs are the primary treatment for the disease. Either the older (typical) antipsychotics or new, second-generation (atypical) antipsychotic drugs are used. Not every drug will work for every patient. It may take trial and error to find the medication that works the best. Your doctor will help you figure out what course of treatment is best for you.
Typical antipsychotics dramatically changed treatment methods when they were first used in the 1950s. The drugs chlorpromazine (Thorazine) and haloperidol (Haldol) helped remove some of the disorder’s stigma. These drugs provided treatment for patients who before would have been put in institutions.
The new atypical antipsychotics have brought even more improvements to clinical treatments. One such drug is clozapine (Clozaril). It effectively reduces or eliminates psychotic episodes. Unfortunately, the drug is associated with a condition called agranulocytosis. This is a potentially dangerous decline in production of white blood cells. It can affect the body’s ability to fight infections. Use of these drugs must be closely monitored for this side effect.
Other atypical drugs include:
Although these drugs don’t cause agranulocytosis, they are associated with other problematic side effects. Some of these include:
People who take these medications must monitor their blood regularly for glucose and lipid changes. These medications are also associated with initial side effects of:
Many of these side effects may eventually subside.
Long-term use of these medications can cause tardive dyskinesia (TD). This is a condition of muscle spasms that occur particularly around the mouth. The spasms may be mild or severe. They may or may not disappear once the drug is stopped. Atypical antipsychotics are somewhat less likely to cause TD.
It’s important to note that antipsychotic drugs can have dangerous drug interactions. Patients should never take any drugs without consulting their doctor first. Even vitamins and minerals may cause problems. Patients should never stop taking a medication abruptly or without their doctor’s approval.
Management of the disease may also require psychosocial treatments. These treatments often come after a patient is stabilized on medication. They are designed to help patients with the daily challenges of living in society. They provide coping mechanisms that help with:
An important part of this therapy involves teaching the individual and family members about the illness and providing strategies for coping. Management of the disease has progressed to the point that many people are able to lead productive lives.
Treatment sometimes includes cognitive behavioral therapy (CBT) for people whose symptoms don’t respond to medication. CBT teaches patients to change their thinking, which in turn can change their behavior. CBT urges a person to objectively examine their thoughts and sensory perceptions. They can learn to ignore the "voices" or other hallucinations. These skills can give people more power over their symptoms.
Substance abuse is sometimes a byproduct of a schizophrenia diagnosis. So drug abuse treatment may also be necessary. Treating both the illness and the drug abuse results in better outcomes than treating only one of the problems alone.
Electroconvulsvie therapy (ECT) is often referred to as "electroshock therapy." ECT is a long-accepted treatment for schizophrenia. Despite its poor reputation in the United States, ECT has long been used to treat schizophrenia in Europe. According to a study published in the Cochrane Database of Systematic Review, there’s no evidence that suggests that ECT is not an effective treatment for schizophrenia. The claim is that it may speed recovery and improve response to medications. Although drug therapy is still the first-line treatment, ECT may complement the work of drug therapy.
An alternative to ECT is gaining acceptance among some experts. Transcranial magnetic stimulation (TMS) creates weak electrical currents with electromagnetics. These weak currents pulse across the skull. TMS has shown to improve symptoms of schizophrenia. In very rare cases, TMS can trigger seizures and fainting. More studies are needed to determine any long-term side eff
Written by: Dale Kiefer
Medically reviewed on: Oct 09, 2014: George Krucik, MD, MBA
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