Treatment Overview

Finding out that you have schizophrenia can be scary and hard to deal with. But you can treat it.

The goals of treatment and recovery are to:

• Reduce or stop symptoms.
• Reduce the number of relapses.
• Develop a personal plan for your recovery by setting and meeting goals for home, work, and relationships.

Medicines help your symptoms, and counseling and therapy help you change how you think about things and deal with the illness.

If medicine and therapy aren't helping you, your doctor may suggest electroconvulsive therapy (ECT). In this procedure, your doctor uses electricity to create a brief and mild seizure. This may change your brain chemistry and help your symptoms.³

If you struggle with alcohol, drugs, or tobacco or have other mental health problems, such as depression, you need to treat these problems too.

Treatment may last a long time, and the need to follow a recovery plan usually lasts for your lifetime. Your treatment and recovery plan may change as your experience of schizophrenia and your life change.

Most people with schizophrenia qualify for health care programs such as Medicare or Medicaid. To find out whether you qualify, check with your local health and welfare agency.

Medicines

Medicines are the treatment that works best for schizophrenia, and you may be taking more than one at a time. They may be used for positive or negative symptoms, but they don't work as well for negative symptoms as they do for positive symptoms.

It may take time to find which medicines are best for you. This may be frustrating. Getting support from your family, your friends, and a community-based rehabilitation program is helpful, especially while you and your doctor are trying to find the best medicines. It also may help to speak with and get support from others who have had trouble finding the right medicines.

If you stop taking your medicines, you may have a relapse. Don't stop taking your medicines until you talk with your doctor. If you and your health care team decide you should stop using medicine, you will need to be checked on a regular basis.

Medicine choices

Medicines used most often to treat schizophrenia include:

• First-generation antipsychotics, such as haloperidol (Haldol), perphenazine, and chlorpromazine.
• Second-generation antipsychotics, such as risperidone (Risperdal) and aripiprazole (Abilify).
• Clozapine, such as Clozaril.

These medicines often are used along with the medicines listed above:⁴

• Lithium carbonate, such as Lithobid and Eskalith.
• Antianxiety medicines, such as clonazepam (Klonopin) and diazepam (for example, Valium).
• Anticonvulsant medicines, such as carbamazepine (for example, Tegretol) and valproate (for example, Depakote).
• Antidepressant medicines, such as selective serotonin reuptake inhibitors (SSRIs) (for example, Zoloft or Celexa) or tricyclic antidepressants (for example, Pamelor).

Side effects

Because of side effects or the risk of side effects, you may be tempted to stop using your medicine. But if you stop using medicine, the symptoms of schizophrenia may come back or get worse.

If you have any concerns about side effects, talk to your doctor. He or she will work with you. Your doctor may give you a smaller dose of the antipsychotic medicine, have you try another antipsychotic medicine, or give you another medicine to treat the side effect.

Some side effects of antipsychotic medicines can be serious.

• Neuroleptic malignant syndrome is a rare but life-threatening side effect of antipsychotics. The first signs usually include a fever between 102°F (38.9°C) and 103°F (39.4°C), a fast or irregular heartbeat, rapid breathing, and severe sweating.
• Tardive dyskinesia is body movement that you can't control.

You may need regular blood tests to check for side effects. Children, teens, and older adults may need to have blood tests more often than other people.