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Commonly used second-generation antipsychotics:risperidone (Risperdal)aripiprazole (Abilify)clozapine (Clozaril)quetiapine (Seroquel)olanzapine (Zyprexa)ziprasidone (Geodon)paliperidone (Invega)lurasidone (Latuda)brexpiprazole (Rexulti)cariprazine (Vraylar)iloperidone (Fanapt)
What Is Schizophrenia? American Psychiatric Association. August 2020.
Schizophrenia. Brain and Behavior Research Foundation.Show Less
Schizophrenia Treatment
With treatment, many people with schizophrenia live relatively normal lives. By Lindsey KonkelMedically Reviewed by Allison Young, MDReviewed: July 18, 2022Medically ReviewedThere’s no cure for schizophrenia, but medications can help minimize symptoms. StocksyTreatments for schizophrenia are aimed at reducing or eliminating symptoms of schizophrenia, including hallucinations (seeing or hearing things that aren’t there), delusions (false beliefs not based on reality), and jumbled speech. (1) There is, however, no cure for schizophrenia. Most people with the disease will require a combination of medications and psychotherapy (talking with a trained therapist), and social services. (1)Getting Schizophrenia Symptoms Under Control
Your doctor may suggest that you be admitted to a hospital at first to help get your symptoms under control.The Prevalence of Schizophrenia How Common Is the Disease
Approximately 100,000 young people in the United States experience an episode of psychosis each year, according to the National Alliance on Mental Illness (NAMI). (2) Psychosis is a break with reality that can involve paranoia, hearing voices, or having other hallucinations or delusional thoughts. Not everyone who experiences psychosis has a mental illness. Psychosis is a symptom, not a disease: It is characteristic of schizophrenia, but psychosis can also be caused by other psychiatric disorders, substances, and a variety of medical conditions. (3)The Importance of Early Diagnosis and Treatment in Schizophrenia
Seek medical treatment immediately if you or someone you know might be experiencing signs of psychosis or schizophrenia. Early diagnosis — and treatment — can improve the chances of a successful recovery. (3) With proper treatment, it’s possible to improve your quality of life by minimizing the symptoms of schizophrenia. Some people have a harder time controlling their symptoms than others do. For most people, schizophrenia will require ongoing treatment, even after symptoms have subsided. (4) RELATED: Early Schizophrenia Treatment Programs MultiplyMedications for Schizophrenia Treatment
Antipsychotic drugs are often used to treat schizophrenia. These medications help relieve hallucinations, delusions, and thinking problems. Antipsychotics work by changing the way certain chemicals, called neurotransmitters, act in the brain. By altering those chemicals, antipsychotics can affect brain circuits involved in thinking, mood, and perception. (5) There are many different antipsychotic drugs on the market. You may hear your doctor refer to first-generation (“typical”) or second-generation (“atypical”) antipsychotics. Newer drugs aren’t necessarily better drugs. Several reviews and studies in adults and children have found that the differences between the classes are relatively small and difficult to predict. Both classes may be about as effective at reducing so-called “positive” schizophrenia symptoms, such as hallucinations or delusions, though second-generation antipsychotics may be better at treating so-called “negative” symptoms, such as depressed mood and social withdrawal. Not every drug will work for every person. (6,7,8)Side Effects of Drugs Used to Treat Schizophrenia
Both older and newer antipsychotics can cause serious side effects. First-generation antipsychotics, which began to be developed in the 1950s, can cause restless movements or muscle spasms as a side effect. While some of the movements or changes in muscle tone are treatable, in some cases people can develop long-term or even permanent abnormal movements. This side effect is typically related to the duration of treatment and is more common in older people. Second-generation antipsychotics were developed later and don’t cause as many movement problems. They are, however, more likely to cause other side effects, such as weight gain, as well as the development of related issues, such as diabetes and high cholesterol. Some commonly used first-generation antipsychotics:haloperidol (Haldol)chlorpromazine (Thorazine)perphenazine (Trilafon)fluphenazine (Prolixin)Commonly used second-generation antipsychotics:risperidone (Risperdal)aripiprazole (Abilify)clozapine (Clozaril)quetiapine (Seroquel)olanzapine (Zyprexa)ziprasidone (Geodon)paliperidone (Invega)lurasidone (Latuda)brexpiprazole (Rexulti)cariprazine (Vraylar)iloperidone (Fanapt)
Antipsychotic Drugs and Possible Side Effects
Older and newer antipsychotic drugs can cause side effects, including the following:Uncontrollable movements, such as tics, tremors, or muscle spasms (this risk is higher with first-generation antipsychotics)Weight gain (this risk is higher with second-generation antipsychotics) and other metabolic effects like development of diabetes and high cholesterolDrowsinessRestlessness Different antipsychotics have different possible side effects; it is important to speak with your doctor about the potential side effects from your particular medication. Antipsychotics can also cause interactions with certain medications and supplements. Discuss all other medications or supplements that you take with your doctor before starting on an antipsychotic. This includes over-the-counter (OTC) drugs, supplements, and illegal and recreational drugs, including marijuana, which has been shown to worsen psychotic symptoms in those with and susceptible to schizophrenia.Medication Adherence and Schizophrenia Treatment
Taking medications correctly can be a problem for people with schizophrenia. An estimated one-third of people with schizophrenia use their meds incorrectly or skip them altogether, according to research published in the journal Patient Related Outcome Measures. (9) That may be due in part to the nature of the illness itself. People with schizophrenia may believe they do not need medications or may forget to take them. They may not understand what’s happening or may feel confused or distressed.Nondrug Therapies for Schizophrenia Treatment
In addition to medication, your doctor may recommend other therapies to help you cope with the everyday challenges of schizophrenia. In 2009, the National Institute of Mental Health funded a series of clinical trials known as the RAISE Initiative to improve schizophrenia treatment. (10)What Is Coordinated Specialty Care for Schizophrenia
A 2016 study found that early intervention after the onset of a first episode of psychosis with a coordinated, team-based approach and low doses of antipsychotic medication resulted in more effective treatment for people with schizophrenia. (11) This team approach is known as coordinated specialty care. A coordinated specialty care team may include clinicians, therapists, and case workers with experience in the following areas: (12)PsychotherapyFamily supportMedication managementWork or education support Other therapies for schizophrenia may include these options: (1) Cognitive behavioral therapy You’ll meet with a therapist to work on your thinking and behavior. The therapist may teach you how to test the reality of your thoughts or perceptions, and help you develop ways to ignore the voices in your head. Peer support groups These are safe places where you can meet people who are going through the same things as you. Professional therapists are usually not involved. Family therapy This involves seeing a therapist along with members of your family. It’s important that your family knows as much about your schizophrenia as possible. Therapists can help your family develop coping strategies and problem-solving skills. Rehabilitation These programs can include job counseling, money management, and communications training. Rehabilitation emphasizes skills that can help people with schizophrenia function better in their communities. Integrated substance abuse treatment Some people with schizophrenia also have substance abuse problems. They often get better results when drug and alcohol treatment are part of their schizophrenia treatment program. RELATED: How Resilience Helped Me Transform My Life After a Brain Injury NEWSLETTERSSign up for our Mental Wellness Newsletter
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ReferencesSchizophrenia. National Alliance on Mental Illness.Psychosis. National Alliance on Mental Illness.Understanding a First Episode of Psychosis, Young Adult: Get the Facts. Substance Abuse and Mental Health Services Administration.Schizophrenia Diagnosis and Treatment. Mayo Clinic. January 7, 2020.Mental Health Medications: Overview. National Institute of Mental Health. June 2022.Pillay J, Boylan K, Carrey N, et al. First- and Second-Generation Antipsychotics in Children and Young Adults: Systematic Review Update. Agency for Healthcare Research and Quality. March 16, 2017.Lieberman JA, Stroup TS, McEvoy JP, et al. Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia. New England Journal of Medicine. September 22, 2005.Solmi M, Murru A, Pacchiarotti I, et al. Safety, Tolerability, and Risks Associated With First- and Second-Generation Antipsychotics: A State-of-the-Art Clinical Review. Therapeutics and Clinical Risk Management. June 2017.Haddad PM, Brain C, Scott J. Nonadherence With Antipsychotic Medication in Schizophrenia: Challenges and Management Strategies. Patient Related Outcome Measures. 2014.Dixon LB, Goldman HH, Srihari VH, et al. Transforming the Treatment of Schizophrenia in the United States: The RAISE Initiative. Annual Review of Clinical Psychology. January 12, 2018.Kane JM, Robinson DG, Schooler NR, et al. Comprehensive Versus Usual Community Care for First-Episode Psychosis: 2-Year Outcomes From the NIMH RAISE Early Treatment Program. American Journal of Psychiatry. April 1, 2016.What Is Coordinated Specialty Care (CSC)? National Institute of Mental Health. Additional Sources Schizophrenia. National Institute of Mental Health. April 2022.What Is Schizophrenia? American Psychiatric Association. August 2020.
Schizophrenia. Brain and Behavior Research Foundation.Show Less