Schizophrenia Treatment Overview

When to see a healthcare provider

Always see a healthcare provider—either your primary care provider or a psychiatrist—if you have signs of schizophrenia. The main symptoms are delusions (false beliefs), hallucinations (seeing, hearing, or sensing something that’s not there), disorganized speech or inappropriate behavior, catatonia (rigid posture, stares), lack of emotion, and becoming less able to do everyday tasks.

Schizophrenia requires long-term treatment that often includes medication, therapy, and family support. Treatment is most effective when started early.

Getting diagnosed

A psychiatrist can usually diagnose schizophrenia based on your symptoms and a physical and psychiatric exam. Tests like a blood test or MRI may be ordered if your provider is concerned that other conditions may be causing your symptoms.

What to expect from your visit

• Your psychiatrist will likely recommend antipsychotic medications. Doctors often start with second-generation antipsychotics (like Abilify and Seroquel), because they have fewer serious side effects than older (first-generation) antipsychotics (Haldol and Thorazine). It may take weeks or months to find the right combination of medications that reduce symptoms with the fewest side effects.
• Long-acting injectable antipsychotics may also be an option for some people, like those who want to take fewer pills or who have trouble following a daily medication schedule. The injections are given every 2–4 weeks.
• Depending on your symptoms, you may be prescribed additional medications, like mood stabilizers and antidepressants.
• If you’re having a severe episode or are in danger of hurting yourself or others, you may be hospitalized until symptoms are being managed.
• Individual talk therapy is often recommended for people with schizophrenia.
• Family psychoeducation, which teaches families how to help a family member with schizophrenia, is a common part of treatment.
• Skill-based programs can help people with schizophrenia find and keep a job (vocational rehabilitation), improve their communication skills (social skills training), and boost cognitive ability (cognitive enhancement therapy).
• Peer support provides emotional support and information about community resources. Peers can help show that living a satisfying life is possible.

Prescription schizophrenia medications

• Second generation antipsychotics: aripiprazole (Abilify), clozapine (Clozaril, Versacloz), olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), ziprasidone (Geodon)
• First-generation antipsychotics: chlorpromazine (Thorazine), thioridazine (Mellaril), fluphenazine (Prolixin), haloperidol (Haldol)
• Injectable antipsychotics: aripiprazole (Abilify Maintena, Aristada), fluphenazine decanoate, haloperidol decanoate, paliperidone (Invega Sustenna, Invega Trinza), risperidone (Risperdal Consta, Perseris)
• Mood stabilizers: lamotrigine (Lamictal), lithium, carbamazepine (Tegretol), valproic acid (Depakote)
• Antidepressants: citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), escitalopram (Lexapro)

Types of schizophrenia providers

• A psychiatrist is a medical doctor who specializes in psychiatric conditions. They can diagnose schizophrenia and prescribe medications.
• Your primary care provider can identify signs of schizophrenia and refer you to a psychiatrist.
• Therapists like psychologists and clinical social workers help people with schizophrenia learn to cope more effectively with their illness.
• Occupational therapists can help establish programs to address everyday activities and occupational responsibilities.

Treating schizophrenia at home

Treatment of schizophrenia usually requires medication and therapy, but there are lifestyle changes that your provider will discuss with you. Some basic recommendations include:

• Don’t use alcohol or drugs.
• Manage stress. Try relaxation techniques like meditation, yoga, or tai chi.
• Get enough sleep. Being tired can worsen symptoms.
• Eat a balanced diet and exercise regularly. Healthy habits may reduce symptoms, improve sleep, and relieve stress.
• Join a support group for people with schizophrenia, like the Hearing Voices Network, to connect with other people who understand what it is like to live with schizophrenia.
• Stick closely to your doctor’s treatment plan, even if symptoms seem to improve.
• Get and stay informed about schizophrenia. The National Alliance on Mental Illness offers information and support to individuals and families.