This article will discuss the diagnosis and common Schizophrenia treatments —a disabling psychological condition that, by some estimates, affects over two million Americans.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), schizophrenia is characterized by a considerable functional decline that follows the onset of at least two of the symptoms described below:
- Hallucinations: Abnormal perceptions (e.g., seeing things that do not exist).
- Delusions: False beliefs that remain unchanged despite contradictory evidence.
- Disorganized speech: Jumping from topic to topic or providing unrelated answers.
- Abnormalities in motor movements: These symptoms present in a variety of ways—as reduced reactivity to external reality, immobility, abnormal posture, purposeless activities, and repetitive movements.
- Negative symptoms: A reduction in normal functioning. Negative symptoms include a reduction in motivation, emotional expression, speech, interest in social interaction, or the ability to experience a pleasure.
People with schizophrenia are more likely to experience certain mental health conditions, like anxiety, depression, and especially substance use disorders. In addition, they are at a high risk of suicide. Therefore, successful treatment of schizophrenia may not only help control the schizophrenia symptoms but also prevent other health problems and reduce the risk of suicide.
Medications for schizophrenia
Research shows antipsychotic medications, antidepressants, cognitive behavioral therapy, and social skills training can significantly improve the outcome for patients with schizophrenia. Perhaps the most important of these treatments are antipsychotic medications. These medications are particularly effective in reducing positive symptoms (e.g., hallucinations and delusions). However, they often do not significantly reduce negative symptoms or cognitive difficulties.
The primary effect of antipsychotics is sedation. Commonly prescribed drugs include older antipsychotics like Haldol and Thorazine and newer medications like Risperdal, Seroquel, and Abilify. Older antipsychotics are used less often these days because of their potential to cause movement disorders (particularly after prolonged use). The major side effects of newer antipsychotics are often metabolic in nature (e.g., weight gain, diabetes). When the above antipsychotics do not work, the drug Clozaril is sometimes administered. Though Clozaril can be very helpful in getting the positive symptoms under control, it is also associated with a rare but dangerous blood condition called agranulocytosis. Therefore, patients taking this medication need to get routine blood tests. Aside from antipsychotics, antidepressants (e.g., SSRIs and SNRIs) are sometimes prescribed, especially to manage depression and negative symptoms.
Other treatments for schizophrenia
As for psychological treatments, cognitive behavioral therapy (CBT) is the treatment of choice. CBT focuses on changing distorted thoughts and dysfunctional behaviors as a way to reduce distress. CBT may also include education about the nature of schizophrenia and how to recognize the warning signs of a psychotic episode, set goals, increase motivation, and cope effectively (e.g., relaxation training, problem-solving, challenging the delusions using logic and evidence).
While medications and psychological therapy can control the symptoms and reduce distress, social interventions are important too. For example, social skills training teaches patients the skills needed to live independently. And supported employment services assist them with finding jobs in the community.
Family interventions might be quite useful too. The family interventions generally focus on helping family members and caregivers find more effective ways to cope, problem-solve, communicate with the patient, set limits, and respond to crisis situations.
In summary, many treatments for schizophrenia exist and have been shown to be effective in reducing symptoms of schizophrenia and improving functioning. It is important to remember that the earlier schizophrenia is treated, the more likely it is that health problems and functional deterioration can be prevented.