How is Schizophrenia Treated?

Question: How is Schizophrenia Treated?

Answer: There is not yet a cure for schizophrenia, although scientists are working on one. Today, the basic goals of treatment for schizophrenia are to:

  1. Control the symptoms of schizophrenia
  2. Improve and maintain the patient’s emotional well-being
  3. Help the patient function in roles such as family, school, work and social groups

Medications Control the Symptoms of Schizophrenia

Antipsychotic medications are crucial to treating schizophrenia.

Medications tend to have some degree of side effects, which may vary a great deal in type and severity among the individuals taking them. It sometimes takes months or years for a patient and psychiatrist to work together to find the best drug or combination of drugs to control symptoms and minimize side effects. Schizophrenia is a chronic condition, and patients will need to take medication for the rest of their lives in order to prevent relapse.

Families and caregivers play a very important role in helping the patient stay on the medication despite setbacks, and to find lifestyle changes to help control side effects, such as encouraging regular walks and a healthy diet to minimize weight gain.

Beginning in the 1950s, antipsychotic medications were extremely effective in reducing the positive psychotic symptoms of schizophrenia. However, the traditional antipsychotics (chlorpromazine (Thorazine), haloperidol (Haldol), perphenazine (Etrafon, Trilafon), and fluphenzine (Prolixin)) often caused serious side effects like tremors, rigidity, muscle spasms and restlessness.

In the 1990s, atypical antipsychotics were invented that have fewer, and less serious, side effects. Atypical antipsychotics prescribed in the United States include clozapine (Clozaril), risperidone (Risperdal), olanzapine (Zyprexa), quietiapine (Seroquel), and ziprasidone (Geodon). Of these, Clozaril can cause a serious side effect (agranulocytosis) that reduces the number of certain kinds of blood cells, which the others do not cause.

However, the others may affect the metabolism, sometimes contributing to weight gain and increased risk of diabetes and higher cholesterol. Individuals react differently to these drugs, and patients and doctors can often find one that minimizes negative side effects while providing greatest relief of symptoms.

Doctors sometimes prescribe other drugs in combination with antipsychotics in order to control other symptoms like depression.

Holistic Treatment Approaches

One of the greatest impediments to recovery for people with schizophrenia is that people often stop taking their medications. Sometimes patients feel dissatisfied with the quality of their lives, sometimes they object to the side effects, and sometimes they simply need some help remembering. Lack of insight, denial and paranoia can also contribute to someone discontinuing their medications. A great deal of research has indicated that the best outcomes require a holistic treatment and clinical management approach, such as the ACT (Assertive Community Treatment) model.

In holistic models, the patient, family, social workers and doctors communicate and share responsibility to ensure the patient maintains the best recovery possible. A treatment regime for schizophrenia should be comprehensive and lifelong, and should include most or all of these elements:

  • Ongoing clinical management by a team including psychiatrists and social workers
  • Psychosocial therapies and rehabilitations can improve self-awareness, address drug abuse issues, etc.
  • Medication compliance monitoring makes sure the patient continues taking medications and attending appointments. This important service can prevent relapse.
  • Housing must be safe and appropriate for the person’s level of independence.
  • Stress management is critical. Symptoms are highly sensitive to changes in routine or emotional stress.
  • Proper nutrition and exercise are help manage stress and maintain a healthy mood.
  • Social interaction is important, but can be stressful. Patients can learn to balance socialization needs against stress.
  • Work supports. Many people with schizophrenia are able to return to work, either the pre-illness career or a new, often less demanding, job. The clinical management team should help the patient find work that suits his or her level of function and ability to handle stress. The Americans with Disabilities Act prohibits employers from discriminating based on mental illness, and requires them to make reasonable accommodations for a psychiatric disability.


Meuser, K. and Gingerich, S. The Complete Family Guide to Schizophrenia New York: The Guilford Press, 2006.

Schizophrenia: a detailed booklet that describes symptoms, causes, and treatments, with information on getting help and coping. National Institutes of Mental Health. (2006) 

Torrey, E.F. Surviving Schizophrenia: a Manual for Families, Patients and Providers, 5th Edition. New York: HarperCollins Publishers, 2006.

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