Schizophrenia Treatment and Rehabilitation Options

There are Many Options Available for Treating Schizophrenia

group therapy
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Since schizophrenia's causes are not yet known, current treatment methods are based on both clinical research and experience and include antipsychotic medications and/or psychotherapy, rehabilitation, self-help groups and education. These approaches are chosen on the basis of their ability to reduce the symptoms of schizophrenia and to lessen the chances that symptoms will return.

Medications for Schizophrenia

Antipsychotic medications are the medicine of choice for schizophrenia.

There are two classes of antipsychotics: Typical (these are the older, first generation of antipsychotics) and atypical (the newer, second generation). The most common typical antipsychotics include Thorazine (chlorpromazine) and Haldol (haloperidol). Common atypical antipsychotics are Abilify (aripiprazole), Clozaril (clozapine), Risperdal (risperidone), Zyprexa (olanzapine) and Seroquel (quetiapine). Atypical antipsychotics tend to have fewer side effects, so they are usually tried first.

Antipsychotics reduce the psychotic symptoms of schizophrenia and usually allow the patient to function more effectively and appropriately. Antipsychotic drugs are the best treatment now available, but they do not “cure” schizophrenia or ensure that there will be no further psychotic episodes. The large majority of people with schizophrenia show substantial improvement when treated with antipsychotic drugs.

Sometimes when people with schizophrenia become depressed, other symptoms can appear to worsen. The symptoms may improve with the addition of an antidepressant medication.

Side Effects of Antipsychotic Medications

Different patients have different treatment responses and side effects to various antipsychotic drugs.

Side effects may include:

Most of these go away within a few days and if they don't, they can usually be corrected by lowering the dosage or can be controlled by other medications. 

Long-Term Effects of Taking Antipsychotic Drugs

The long-term side effects of antipsychotic drugs may pose a considerably more serious problem called atardive dyskinesia (TD), a disorder characterized by involuntary movements most often affecting the mouth, lips, and tongue, and sometimes the trunk or other parts of the body such as arms and legs. TD mostly occurs in patients who have been taking the older typical antipsychotics, though it can happen in people who take atypical antipsychotics as well. In most cases, the symptoms of TD are mild, and the patient may be unaware of the movements.

Antipsychotic medications developed in recent years all appear to have a much lower risk of producing TD than the older typical antipsychotics.

The risk is not zero, however, and they can produce side effects of their own such as weight gain. In addition, if given at too high of a dose, the newer medications may lead to problems resembling Parkinson’s disease, a disorder that affects movement. Nevertheless, the newer antipsychotics are a significant advance in treatment, and their optimal use in people with schizophrenia is a subject of much current research.

Rehabilitation for Schizophrenia

Rehabilitation programs may include vocational counseling, job training, problem-solving and money management skills, use of public transportation, and social skills training. These approaches are important for the success of the community-centered treatment of schizophrenia.

Individual Psychotherapy for Schizophrenia

Individual psychotherapy involves regularly scheduled talks between the patient and a mental health professional such as a psychiatrist, psychologist, psychiatric social worker or counselor. Recent studies indicate that supportive, reality-oriented, individual psychotherapy, and cognitive-behavioral approaches that teach coping and problem-solving skills, can be beneficial for outpatients with schizophrenia. However, psychotherapy is not a substitute for antipsychotic medication, and it is most helpful once drug treatment first has relieved a patient’s psychotic symptoms.

Family Education

Very often, patients with schizophrenia are discharged from the hospital into the care of their family, so it is important that family members learn all they can about schizophrenia and understand the difficulties and problems associated with the illness.

Self-Help Groups

Family and peer support and advocacy groups are very active and provide useful information and assistance for patients and families of patients with schizophrenia and other mental disorders.

Sources:

"Schizophrenia." National Institute of Mental Health (2016).

"Mental Health Medications." National Institute of Mental Health (2016).

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